HomeMy WebLinkAbout1753 Q~clu~
~~~;on of l~amicile ~nd Gitiier~shz~
o~r~~c srn'TE AND CUUNTY TAX ASSGSSUR, 2'720fi4
S~ . Luc ie ~nUN7'Y, 1~ 1.ORIUA:
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Tliis is my drelaratic~n c~f Domicitc and Citizensltip in thc Stalc of Florida that 1 atn filing this tlay in ~
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.~~:cordancc, and in conformity with Scctio 222.17, Fiorida Statutcs. ~
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I was forn~erly a lcgal residcnt of _ ~ and 1
(c~~r) ' (s~s~~~
resided at . Howcver, I have changed my domicile to
(Street and Number)
a~1d an and have becn a bona fide residcnt oF thc State of Florida since day of
now 0 G~~ d `
_ _ ~ , 19~ and i /~csidc at ~ /
~ (Street and Number)
. St. Lucfe County, Florida,
(c~tr) -
aa~d this statement is to be taken as my declaration of citizenship, actual lega! residrnce and domicile in the State
.~C Florida.
(Inseri here snY p~rtinent facts, such az sale ot prope~ty or busincss. or relirtquishment ot employment st tormer
domicite. rrmoval of family lo ne?v domicile, purchau of home, etc.)
Entering children in school:~ Homestead Exemption: ~
o~y
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- C~~RK GI~.CU1T COVRT Y~
RECOaO ~ER~fifO
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~ I FURTHFR CERTIFY that I wiil register at my iocat address when the registration books reopen, and
€ comply with all other requirements of a tegat resident of tt~is State.
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g I FURTHER CERTIFY that 1 have no inteniion to return to my forn~er domicile, and I intend to remain in
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~ S t. Luc ie County,
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~ Florida, permancntly. (c~c~~
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' Swgrt~~t4~ana s~Cntiei~~ be;orc me this day of 3 0 7 ~!l e-
; Q , . ~ ing a ress
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; A.~. ~ 9~. ~f .~~r/1G[
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' :ROCsE~i~~ ~ yC RK CIRCUIT COURT ~
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~ (To be eaeculed in duplic~tr ~uJ oriE~inal (ilr wilh ( I~rk Circuit Coutt. and Juplic~te with Ta: Assesstx)
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_ go~K ~22 P~~E 1 ~ 52
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