HomeMy WebLinkAbout1365 Declaration of Damicite and Citi~enship
TU TIlE S1'ATE AnU COUNTY TAX ASSt:SSOR, ~
s t. Luc ~e 2~1.803 `
CUUN7'Y, l~I.ORIUr1: ~
Tl~is is my dcclaration of Domicilc and Citizcnship in the Siat~ of ~lorida that 1 am filing this day in ~
accardancc, and in conformity with Scrtiou ~22.17, Florida Statutcs.
I was formerly a lcgal residrnt of _ ~~~'r~~ , • and I
(city) (State)
n:sided at B«~ ~°2- . However, I have changed my domicile to
- (Street and Numbet)
and am and have becn a bona fide resident of the State of Florida since ~~~C day of
now
- , 19_z 3 and I /~cside at - ~ ~ ~ ~
(Street and Nu )
^ St . Lucie ~ County, Florida,
i~~r) ~
and this statement is to be taken as my declaration of citizenship, act~ial lega) residence and domicile in the State
of Florida.
~
(tnsett here any pertineot facts, such as sale of pro~+erty or business, or relinquishment of employment at tormer
domic~7e. removal o( family to new domicile, purchase of home, etc.) ~
t
Entering children in school;~ Homestead Exemption: ~ '
. t
~
,
FlLEO +lNp RECp~OE~
n LUClE ~ ~RAS~ 1~
~ RDCER
RECOF
~ y ~~;'~UlT COUAf {
• E FtE~~
- 3 z 3s PH , ~
T~I
2'~~8U3
~ . I FURTHER CERTIFY that I wil! register at my local address when the registration books reopen, and
comply with all oihcr requirements of a legal resident of tl~is State. ~
; I FURTHER CCRTtFY that 1 havc no intention to return ta my former domicile, and I intend to remain in
;
` t=-r. /~,~~c~ , St . Lucie , Count
Y,
. Florida, pcrmanently. <<'"'~
~ ~ ~ '
-c~•--
(Name
~ ~~:~G ~ ' C' ~ _ ~~Gf ~`r ^ '
0.. ,p.~ -
: - : - - `f (Address) ~
; - . ~ ~ ~ ~ :
~ .~S~ii,i io .,~~=~tgc~ibrd tsr:forc mc chi, day of C lU , c~ ~~t . y o~2
~ • ;'.,~ta t`: ~ •.j~ _ .
. . r_.. . . .y~ ~k~ y >
~ ~,'r - , A. D. 19 ~ c. ~ o
~ ii , `
':~~-R~6~,t~~ TKAS, CL K CIRCUIT COURT
"'`~--r-~»~+~-=~-.------ - -
~ - By C, ~1 - SOOK ~'AGE 1 JU~
Depu~~ c k
(Tu he .~rcutrJ in JupGc:d~• :~nJ ~.rigin:~l t~ ~it W ith e Yrrk ('ircuit ('~.urf. :~nJ .lu~rli, ale ti~illi Ta~ Asscswr)
- _ ' • - _ ~
r, ~ x,~ }s ~
.b . . _ -.x
~ ~ -
.n. ..mrs.~:.