HomeMy WebLinkAbout2535 Decl~~atic~n o~ Dor~~cit~ anc~ ~itt~ens~r~~~p 2~~,~ .
~i'O Ttit: STATt: At~U CnUi~TY 7'AX ASSl~SSQlt, '
St.Lucie
COUI~TY, FLORII)A:
'I7~is is my dcclaration oi Domicilr and C'itizc~~,f~i~~ in th~ Stat~ ~~f 1=lorida Ihat 1 am tilii~g this day in
accoraance, and in conformity with S~ction "'"'''.17, ~=torida Statutrs. ~ • ;
I was formcrly a Irgal residcnt of _ S T. ~ w`~" `~"'"`4 O~'` ~O"~`~"~`'~ ~
_ , ' and I
~(ci~r) ~ ^ isace)
residcd at _ However, I have changcd my domicile to
(St~tet and Number) ±
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and am and have becn a bona fidc rrsidcnt o( thc Statc of Florida since j S__ day of
_ , 19~ 3 , and 1 /res de at 3 ! ~ $ ~ ^
(Sereet and Number) ~
S f. c~.:~.. S t. Luc ie ~
~ _ , - County, Florida,
(c~~y~ ~
and this statement is to be taken as my declaration of citizenship, aciual legai residence and domicil4 in the State ~
of Florida.
(Insert here any perlinrnt facis, such as sate of properly ot buciness, or relinyuishment ot employment at former ~
domicile, removal of family to n~w domicilr, purchase of home, rte.) ~
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Entering children in school:~ Homestead Exemption:
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ST.~u~;C ~,~zuN~r FcA.
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i I FURTHER CERTIFY that I wil! re~ister at my local address when the registration books reopen, and
~ comply with al! other requiremcnts of a legal residcnt of this State.
; I FURTHER CERTIFY that I have no inte~ition to return to my forn~er domicile, and t iniend iu ri:~i~ain in
~
~c~-,,~- 5 ~-c~.~-c~_ St . Lucie County;
? Florida, permanently. (c'"'~ ' '
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; Sworn to and subu:ribcd befor ~ inc this _ day ~f
r L~-ue-~~Yt..~-~ ~ 73 to ~.a'~E. ~ o= ~ ~ E
- A.t). 19---- c~ _
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ROGER POITRAS CLERK CIRCUIT COURT • f.f`-~~~'•~~ ~
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(Tu Mc excu~trJ in dupli~.~ir and ut~~ ~n.+l (drd ~~qt~ ("irrk ('irauit C~~utt. arrd d~+~~licalr i+iib 7at /1st,cszur ~1.
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