HomeMy WebLinkAbout1473 ~ i
Deci~ratian o~ Da~nici~~ and GifE~ens~ip ~
7'O THt: STATL: ANU CUUI~'TY "1'AX A5St:SSUIl,
_SC .Lucie ~~~$~8
COUN'TY, I~1.ORIUA:
Tliis is tny drelar:~tion of Uonticilc and Citizrnship in thc Statc of riorida that 1 am filinb lhis day i~i
accordanc~, and in conforntity with Scction 222.17, rlorida Statutes..
~ . . ,
I was fornierly a legal resident of , and 1~
itr) . (st,ce)
residcd at ~ . However, 1 have changed my damicile to
a-s~ (Sireet and NumArr)
and am and have bcen a bona fide rc~ident of thc State of Florida since ~ day of
now ~ ~ ~
, i9~3 and 1 /~cside at -
(Street and Number)
~ ' ~ , St. Lucie County, Florida,
(cicrl
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. -
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(insert hert any pe~IFnent facts, such as sale of property or business, or relinquishment of employment at formcr
domicJe. temoval of family to new dorriicile, purchase ot home, etc.) ~
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Enter~ng children in school;~ Homestead Exemption: ;
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~L~ CIR~ULTTDIAbT ~ ~
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~ I FURTHER CERTIT'Y thr~t 1 will register at my local address when the registration books reopen, and
; comply with aq other requirements of a tcgal resident of this State.
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= I T'URTHER C Y that 1 have no intention to return to my former domiciie, and Y intend to remain in
~ St . Lucie ;
~ ` ,
County,
Florida, permanently. c~"r) ~ _ ~ ~/j~4 ~f~ ~
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~''1'.I,..,^~/~'. D/~•I~ ~.t .t ~ ~
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•••.i • S r • I L•P - . . (Name) , ~ ;
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' S~ tn•~e~it{~•5~ '~ribcd bcforc mc this day of ~
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~t--~~~ l~~=tsu~ , A.t~. ~ .74 .
ROGER~O'ITRAS, CLE . CTRCUIT COURT f G~
; - - - 222 ~,,~E 1~7~ -
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(T~~ he rarruleJ ~wiluplicatr .~r~( uni:~nal tit ~v~h f~teri ~-~~cu~t ('~rurt. eteJ dupl~. ~li• ~vhh I:~x A+~•~tot) ?
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