HomeMy WebLinkAbout1608 ~ S
[~~ci~:c~~tia~n of Domicite and Citiz~nshEp
2'~1s~3 i
"TO "I'I11: S7'A"1~1: Anv ('OUNTY '1'AX ASSL~.S50R, t
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_ St.Lucie ~OUN`fY, FLORIUA: ~
Ti?is is my ~icclaratic~~i of Domirilc and Citizcnalii~~ in ihc Statc of Florida ihat 1 am Cling this day in ~
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accorclanc~, :utd in conforntity with Scction ~22.17, Hlorida Statutcs~ ~
1 was Porn~crly a legal r~sident of _ d N~ s , tiE~ ~ c~~.s and !
~c~~r) (s~au) ~
residcd a1 _,3 W~n ne ? r R- /~d ~ . Howcver, 1 have changcd my domicile to ~
(St~est and Number) ;
and am and have Ixen a bona Cde resident of the State of Florida since ~ 9'~' day of ~
now ~ ~
~zr c~r B.e , 19 7~_, and 1/reside at C'• r~ru c/'•~.~K ~i~r e?, l3o x 3~~ S~
(Street and Number) ~
~o,~ ; ~ , S t . Luc ie County, Florida, '
(c~iy) i
and this statement is to bc taken as my declaration of citizenship, actuat legal residence and domicile in the State ~
~
of Florida. ~
(Insert here anr prrtinent facts, such u sale of property or business, or relirtquishmee~t ot er»ployment at fotmer ~
domicile, ~emoral of family to new domicile. putchase of Aome, etc.) ~
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Entering chil.dren in school:~ Homestead Exemption: ~
. 2~Igs3
ST
LUClE COUNr a~E,j
ROCER POITRAS ~ i
CCERK Ct~CUIT COf/Rt
AECOR~ ~vFRjflEp
_ ~ 1
2 il PM l~l ~
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I
i ~
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~ I FURTHI;R CERTIFY that I~vilf register at my local address when the registration books reopen, and
; compl}~ ~vith all other rec~t~irements of a tegal resident of this State.
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E ,~I F'URTHER CERTI~Y that I have no intention to return to my fornier domicile, and I intend to remain in
: i_`' St. Lucf.e ~
~ :.t~ t ` County
~ Florida, permancntly. (c~~r) ~ T
:
} .f,,;JJ r~C ~ • ~ ' . / .c •
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' ' ~i , ~ ~ToyeE. (Name) ~U~iqQl
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• o , y . YCiC ~ ...3 ~ ~f / t
Y . (Addr~u) ~ ~
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~ $ivprrr.~o ~na,suhs~;ribrd befc~rc mc this d:ry of ~ ~
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` A.D. 19__7_4_,. ;
- ~tOGER POITIt~S CLERK CIRCUIT COURT ~
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?;1. ~ ~ t~, e-~ l~.c~'~_ 0 R ~
a ' U: ~ puty C 1. c rk BOOK 9~f ~so~
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(i~~ fir r.rt.~l~•~: in Jtt~•li._.dr and i~rip~n.~l filyd ~•.i16 l'Ir~k ('u~ui~ CouH. ~n4 Juplic•rtr ~vith Tax A~utiwr)
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