HomeMy WebLinkAbout0647 I~~cl~r~~EOn_ af Do~i~E~e ~r~ C~~~z~~~ ~~tf~ ~
"10 TIIL STATI: AND COUN7'Y TAX ASSGSSOR, 2`71330 ±
St.Lucie `
COUNI'Y, FLORIDA:
Ti~is is my drelaration of Domicil~ and Citi•r.cnship in ihc Statc of rlorida that 1 am lilinfi this day in
accardancc, and in canformity ~viti~ Scction 222.17, Florida Statutcs. • ,
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I was formcrly a lcgal residcnt of a~-° ~cf t/~N~ ~~c1f r e W O r~ and I s
n/ , (c;tr) stste) ~
n;sided at a~0 ~~Q G~r U~/UL~t° , However, I have changed my domicile to ~
(Street a Number) , Sr ~
and am and havc been a tiona fide resid~~nt of the State of Florida since day of ~
;
now
T~-~- ~ ~ , 19Z., and 1 /Ecside at ~ ~Q ~1 ~Qti ~/r'/ V(r° '
~O ~ ~ u ~ %p (Stttet and Numbct)
r ~J St. Lucie County, Clorida,
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and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in thc State
of Florida. -
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(Inxrt here a~y pertinenf tacts. sucA u sale of property or business~ or tel+nquishment oi employment at lormer '
domie0e. removal of family to new domicile, purchue of Aome, etc.)
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Entering children in school:~ Homestead Exemption; r
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FIlEO AND RECOR p ~,A
ST.I!l~1E CO@NTY Z~, y~
- ' ROCER ?01?RAS
- . CtERK CiRCU~? COURT
. - R~CORD VEP.tF1E~
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2'~1330 ~ ` ~
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I FLJRTHER CERTIFY that I~vill register at my local address when the registration books reopen, and f
comply with all other requirements of a legal resident of this State. :
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~RTHER CERTIFY that I havc no intention to return to my former domicile, and 3 intend to remain in ~
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Co r-f- S~_ ~(,cC~~o St. Lucie County, ~i
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~ Florida, permanently. cc~~r~ ~
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= ~ Ltil'', Cp . (Nsme) `~E
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_'''~,•ti~ r!~_',f_~ (Addr ) . :s
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S"xorn~#o~~nd sui3sqrficd befor~ me this ~ day ot ~
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r~~~~.~ . eG , n.D. 1~73
, ltt'7C3~3R~`~~`SITRAS, CI.~RK CIRCUIT. COURT " '
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(To I~c e~ctulcJ in uplicrtr anJ ciri~~in.r JrJ w~lh l'I:rA Circ~~it ['uurl. nuJ dupli. alc wilh 'ta[ A~scssat)
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