HomeMy WebLinkAbout1339 Declaratian of DomicE~e an~ Ci~cizen~~:~
To Ttit~ sTn~r~: AND COUNTY 7'AX ASSI~ SSOR, 2696S3
St.Lucie
- _ COUNTY, 1~ LORIDA: -
Tl~is is my dcdaration of Domicik and Citiz~nship in th~ Statr of rlo~ida that I am filii~g this day in
accordancc, and in conforniity with Scctiun 2~2.17, Floricla Statutcs. .
I was formrrly a Icgal residc~tt of ~~/L°~D/U C~ di~~ j
(city) (s~ate)
resided at ~2''~ v i `~~~1~f.:~/~L . Iiow:,vc;, ; lja:e cha::~ed my domicile te
(Strcet and Numbrr)
ar?d am and have becn a bona fidr rrsident of tl~e Statc of t~lorida since day of
O e T~ g now
- , 19 ~i~, and I /Ecside at ~~~_~~u~OQ~ ~
(Street and Number)
~/1'2 C~ _ SC. Lucie County, Florida,
~c;~y~ '
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicite in the State ;
ot Florida. €
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(Inxri here any pertinent facts, such as sale of pr~perty or business, o~ relinquishment ot emplorment at former
domicile, removat ot family lo new domicila, purchase of home, rtc.)
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I FURTHER CERTIFY tl~at I will register at my local address when the registration hooks reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I iiavc no intention to return to my former domicile, and I intend to remain in
~ J-~l _ - _ St Lucie
~ ~'l~Jt.(°_ ~ , • , -CauniY,
~ Fiorida, permanentiy. «''y~ - ~
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_ 7 • ~ • ; ' C = ` (Addresc) -
, ,$n;vta~n~to qd'sf~l~r~bed hcforc mc this da of _
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A.n. ~ 73 .
ROGER POITRAS, CLERK CIRCUIT COURT "
~ - -
' ~ ~ . ~«-~-lu~L ~
-By--- ~ -
; Deputy Clerk_--
(To tM cra•cuted in Juphc~~c aird ~~tr,•en.tl tdrd aifh l'Icr1. ( ita'uit C~~url..~nd Jupli:ale ~~'ilh Ta~ Ac~«tu~)
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