HomeMy WebLinkAbout1357 . ~ ~
Q~cl~c~ation of ~om~c~le ~nd ~itiz~ ~is~~;~
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TO THI~ S'TATI: ANU COUNTY 'I'AX ASSI:SSOit, 2'71'795
_ St_.Lucie , T COUNTY, FLURIUA: ~
Tliis is my deelaratia~ of Domicil~ and Citizcnship in the Stat~~ of Florida that 1 am filinb this day in
accordance, and in conformity with Scctio~ ~22.17, Florida St.~tutrs.
1 was formcrly a Icgal r~ ident of _ , ~ nd 1
( x) ~st.~ ~
resided at . However, 1 have changcd my damicile to
(str x~~ne~~~ ~
and and have been a bona f7de msident of the State of F rida since day of
now O. ~
~ , 19~ and 1/~reside at ~ ~ 7 i
(St~eet and Numbcr) ;
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,L.~.Q~~ . St . Luc ie County, Florida, ~
(c~~r) .
and this statement is to be taken as my declaration of citizenship, actaal lega! residence and domicile in the State
ot' Florida.
(Insert here any pertineot facts, such as sale of property or business, or relinquishment of employment at former
domicile. tcmoval of family to new domicile, purchase ot home, etc.) .
Entering children in school;~ Homestead Exemption: ~ f
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I FURTHER CERTlFY tliat I~vil! rcgister at my local address when the registration books reopen, and
~ compty with alt other requirements of a legal resident of this Statc.
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~ 1 FURTHER CFRTIFY that I l~avc no inicntion to return to my forn~er domicile, and I intcnd to remain in fi
F - 1
C~' St . Lucie ~ Count °
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_ . Florida, pcrmancntly. cc'"'~ ;
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, _ _ (Name) ~ ~
` " ! ' CO .Z~ ~~l/j ~ r i ~ S ~
E C~•~;_ s
i ,.•'g\i'% ..y : - - ~
` ' •a ~ . i\ ~ (AdJress) ~
~ - V ~V _ . ~ I~ . . ~
- S~14iii .tp and sulisd~i3~cd~cforc mc this d~ry c~f
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RC3C~~ Y'~~CA~:~ C K CIRCUIT COURT
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~ ' ~ 3U01( 22~ PAGf ~LJ~
- ~ _ r.~y . ~ _ _~c _ v~ .
llep ty C er
(Tu be rxrculyd in`duplir.~~~• :~ud ~.ri;:u~ ~l drJ ~nth i'Irc~ ['~rcurt t'~~urt. anJ duplicafr xul~ 7ra Asx•:.L~rr)
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