HomeMy WebLinkAbout0635 Declaration of Domicile and Cit~~~nship -
'f0 Tlll: STATI: AN1) COUNTY TAX ASSESSOR, 269133 '
_ St.Lucie ^ __~OUN7'Y, FLOR11)A: ?
• ~
This is my dcclaralion of Domicil~ ,~nd Citizri~ship in the St.~te of rtorida that t am Cling this day in ±
i
accordanc~, and in conformity with Scction 2?2,17, I~larid:~ Statutes. ~
1 was formerly a legal reside~~t of ~2 , ~'~A and 1 t
~c~~y~ ~s~.c~~ ~
~ ~ i
residcd at - ~_~2~~ However, t have changed my domicile to ~
(Sttcet and Number) ' ~ ~ ~
and am and have becn a bona fide resident of the State of Florida since _ ~ day of +
~j now ~
~'v d v~~ b-R~-- , 192.~, and 1/r~sidr at 3 j
~O~ ~ ~ ~ / G ` (Stteet snd Nu r)
.~C ct , St. Lucie County, Florida,
(~~r)
and ihis statemenf is to ta!sen as my dcclaration of citize~iship, actual legal residence and domicile in the State
of Florida.
(lnseri here any pertinrnt facts, sucA u salr of prope~ty or business, or reli~quishment of empioyment at to~mer
domicile, removal of famity to new domicite, purchasr of home, etc.)
Entering children in school:~ _ Homestead Exemption: L.~
~i~ ~~rv •L y ~i~ ~Lo ,u ~ ~ _
J
~~i,e , s T~"C~, T ; ~',yL Lo ,v
c
~ ~ ~ s .~il, ~C-'~~l_~ ~ ~ ,v - ti ~
~o ~E
c~~
~f~ ~
1 ~ . ~ ~ y,.,~ /WiO~~
c
~`V~ !A~
~ v£~~f~p '
. ~x~?13 ;
~
,
M~~'
4
269~'33
~
- 3
i
t
~
I FURTNER CERT[FY that I wiil register at my local address when the registration books reopen, and '
comply with all other requirements of a Icgal resident of this State.
I FURTHER CEKTIFY that 1 have no intention to return to my forn~er domicile, and I ir~tend to rernain in
T~ 3 I/~,~~ ~ e. Po n.~ s L~~~ i t~, St . Lucie
, County,
~ Florida, permancntly. (c'ty~ `
_
.
. - c-
~ ~ ~ ' ~ - -
~ ,iCC"•. , ~ (Name) i
'v . _ _ ' . . ~ . ~ ~ ~~]~///J I
~ 1... ? r_ ;b,'. . ~ _ _ ` _ I ~
't P ~ } /
~ ~ (Address)
= . ~ : q i~r.~ l C : {s ~ - .
'Swoen.tp;antt
suli'Scribc~t b~fore me this day of -
',~~~:r..~~. -111~.QL0~--, A.D. 19---73_, .
ROGER POITRAS, CLERK CIRCUIT COURT
- - -
. ~ ~ . ~~aK2z1 f:~~E b~5
rnC ~
-IIy Depuk}? CL
(To t~e rarculed in Juphc,~r and un; ~n.~1 ~1~•d ~~~th ('IrrA l'irc~~it C~~url. anil duplicatr ~~ilh Ta~ Ascess~~r)
i
< _ ~
--c_.':~-: