HomeMy WebLinkAbout1236 Dect~ration of Domicile and Citiz~nship f
~~o ~~ii~: s-rn~-~: nh~n covn~~'Y 7'A~C ASSl:SSOR, 2695'~
^ St .Lucie i~_ COUN"i'1', FLORU)A: s
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'n,;•: nf 1)nmicile and Citiunship in thc State at Florida that 1 atn filing this ~lay in
accordancc, and in confonnity with Scction ~?~'.17, Florida Statutrs.
1 was fornierly a Iegal resident of , ' L ~ t~ `~~tL~ t,G~ ~
~c~~r~ ' _ and I
(state)
resided at _ . However, 1 have changed my domicile to
(Street a~d Numbrr)
and am and have been a bona fide residcnt of the State of Florida since day of
- now ~
f ~ ~ , 19 Z~, and 1 /residc at q ^ ~G~ ' -
~ ~ ~ treet and Numbet)
~ St. Lucie
1~~~-~~~ . County, Florida,
(c~~~ )
and this statement is to be taken as my deciaration ot citizcnsl?ip, acii~al legal residencc and domic~le in thc St~te
of Florida.
(Inutt here any prrtinrnt facts, such as sale of property or business, or relinquishmrnt of tmployment at former
domicile~ removal ot family to new domicile, purchase ot home, ete.)
Entering children in school:~ Homestead Exemption;'" ~
F LED ANa REGO QE
S~. lUC1E c011111~ F
ttOC ~ PO~fRAS ~
REGDRD Y~Rt~f1EQ ~O~RT
~ 30 3 ie PM'~3 ~
~ s~s~7s . - -
; •
I FURTHER CERTIFY that 1~vill register at my local address when the registration books reopen, and
comply with ali other requir~ments of a legal resident of this State.
I FURTHER CERTIFY that I liave no intention to return to my forn~er domicile, and I intend to remain in
~
St. Lucie
, County,
~ Florida, permanrntly. cc~cr~ - \
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Swi~tl~tp and~ubt;~ibed before me this ~-d day of ~
,
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. ~ ? 1 ~
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~ 't`•~~ cl~~~-, A.U. 19--73--
,~tO~BR~ ~ITRAS, CLERK CIRCUIT COURT
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('(o he execulcJ in Juplic~lr :?nJ un~t~ ~.~1 lil. d witl~ l'Irrk Circuit ('uurt. rnd ~III~~II~
Jlf KIIII 7~~ Acce~wr)
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