HomeMy WebLinkAbout0819 Decl~ration of Domicil~ ar~d Citizenship ~
"TO T11G STATI: AND CUUNTY "I'AX ASSt:SSOR, 2~1429 ~y
_ SC.Lucie ^COUN1'Y, l~LURIUA: -
Tliis is my dcclaration of Domicilc and Citi-r.cnship in ihc Statc of Florida that i am Clin~ this day in ;
. ~ ;
accordance, and in conformity ~vith Secticm 222.17, Hlvrida Statutcs. ~
/`i ~o /`~p s
1 was fo~tmcrly a Icgal residrnt of ~ 4~- c~! ~ir-~~-~i~ ~f"~C~g~ and I ;
<c~~y (sace) ;
resided at ~ 7~ . However, I have changed my domicile to
(Street and Numt+rr)
and am 'and have been a bona fidc resident of the State of Florida since day of ~
now ~ p
~..~7~~~~-~'?~ ~ , 19.~Q, and ! /~cside at 9 ~
~ (Street and Numbec)
~p~~'~~: .c~~ ~ . St . Lucie ` County, Florida,
(city
~
and this statement is to be taken as my declaration of citizenship, ach~ai legal residenee and domicile in the Sfate ~
of Florida. ;
4
3
i
(Insert hete a~y pe~linent facts, such u sale of property ot businest, or relinquishment of employment at fo~mer ?
domicile. removal ot family to new domiciit, purchast of home, etc.) F
i
j
Y
3
~
Entering children in s~hool:~- Homestead Exemption: ~ ~
~
- ;
. ~
. ;
~
~ €
~ ~ ~
~~~~t~~ ~
~oc~ a
r°o''~~.'r~m',?s
t''~ S` ~
et~~r c~~~~urcou~t ~
- ?'r.OR~ ~Ir^:F; ,
~
~ 1~ IQ 3~ ~'13
2'11429 ~ - -
,
. ,
.
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in >
#
~~f ~.c.~~j ~t. LuCie County, i
, .
~ Florida, permanently. «''y~ ~ s
,I j r.,. I / . ~ r t a
- .)t~.~! ~ ~~~~'~:+,n ~ - . ~~r~~ i
'L`• *
. - •,y~'• . ~ `t• ' ' • ~ ~L
~ ~ ~ • ~ _ _ UdArcu) , • ~
. . , : ~o~z~ r,1° •
` ` ' • . / , Y -+=~C-~J 3-3 ~a/ ;
;~51~!orn to and~ sabscritied bcfore me ihis ~ da of ) / ~
~r•::n;:-~f';-' --PC _ A.D. 19- 73~ ~
~
R~GL'`~'~,POITRAS, CLERK CIRCUIT COURT ~
• - i
_ _ _ :SZ - - _ . . _ - ~ R 222 ~ti{ 8i:~ ' ~
~ - U - B~GK
. Deputy- C1 ,
(To bc cxrcuted in duplicrte ~nJ uti~:in. t~lyd ~~ith Clrrk ('ircuit C~~url, anJ Jupli.ale ~~•ilh Tax Acussor)
` -
~;r.~.~ ~
° ~ ~ _