HomeMy WebLinkAbout1265 ~ '
t~~ci~ration of ~om~~ite and Citiz~c~sh~~
'1'U Ttll: STATI. n~.~ cou~~rv TAX ASSi'SSOtZ, '2~1~~5
T St .Lucie ~.OUNTY, I=LORtI~A:
Tl~is is nty clrclar,~tioi~ of Don~icilc and Citi~rnship in thc State af I~lorida that I am Gling tizi~ day in
accord:~ncc, a»d in conforn~ity with Scction 22~.17, Florida Stati~tcs.
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1 was tormcrly a lcgal resident of -s;~1~~~~ -n ~'~-"'L~"''-"'`-~ and 1
~c~~r) (s~.i~~
resided at ~ ' . However, I have changed my domicile to
(3ireet and Numbet)
and am and have been a boita fide resident of tlic State of Florida since ~~5 ~ day ot
~ now .
-~-'c , 19_ ~
3_, and I /~esidc at ~ ^Q ~ ~ ~
(Strce and Nu ber)
S~ . Lucie County, Florida,
~ ~ .t ~~,r .
~c~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicite in the State
of Florida.
(Inserl here any pertinent facts, such u sale ot property or busi~ess, or relinquishment of employment at former ~
domicile. removal ot family to new domicile, purchase oi Aomr, etc.) ,
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Entering children in school;~ Homestead Exemption; ~
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RFCORD VER!~~EO........,~ ~
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~ 1 TURTHEK CERTIFY d~at I will register at my l~cal address when the re~istration books reopen, and
~ comply with all othcr requirentents of a iega! resident of this State.
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' I FURTHL'R CERTIFY that 1 l~ave no intention to return to my farmer domicilc, and 1 intend to rcmain in d
` ~ , _ St . Lucie , County,
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, Florida, pcrnlanently. '
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P l~~`~
(Name) ~
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wtti~~i,to ~~~siy~~ribed b. for~ m~ this day of
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•~C~~f~l~~~ _ R~'~,'TRAS, ERK CIRCUIT COUItT
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liE~~~~_i~y t: ~r
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( f~~ hc c~r~ utrd in du~~li~ .~t~• :mJ uri~ n~.~! tilyd ~.~Ib t'Irt? ('~rcn~l ('~~url. ar~? Juplic ate ~a~th T~x Astirs~ot)
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