HomeMy WebLinkAbout2293 De~:lur~~EOn Q~ L n~ic:'w C~ ~~?e~~: ~~.~~'s,'
fc~ "1'ill: STATL' AM~ C'vUNT1' 7'AX ASSI~:SSUIl, ~~~~~J
St.Lucie
CUUI~I'I'Y, f~LnRiDA:
Tl~i~ is my drela~ation ~f Uonticilr and C'itiicnshi~~ i~~ !hc Slatr of Fic~rida ihal 1 an~ 1'ili»~; this ~lay in
.+«~c~rdancr, ai~d in co~~fc~rmity ~vilh Scctien 222.17, F~lori~i:? Statutcs.
' ~ ~~.~c..~ .
I was formrrly a le~;al rrsidrnt of -~'~^f->-,t t~-r_t~_.r~~' ~'c~, , and I
~ (c~ir) ~s~~~r~
r~sidcd at _s ~~Ql~'__.~~~'~~L~li Nowcvcr, ( havc changed m~~ domicile to
Strect and Numberj
and am and havc b~en a bona tidr rcsident of thc State uF Florid~ since 3L~ ~j`' day of
- - ~ now ~
,
- ~ ~C`~''~. ~ , ! 9~~, a~~d I /~e.ide at ~~..=szz~t~c.o e<<e~~t~ 2,ce~
(Sirret and Numbcr)
/cL~ . f~,~_~± St . Luc ie County, Florida,
- (c:~y) ~ ` .
and this statement is to be taken as my drelaration of citizenship, actual l~gal r~~~idence and domirile in the State
of Florida. - t
~
(Insert hete any pertinrnt facts, such as sate of prupcrty or businrss, or telinquishment of empioyment at formtr ~
domicile, removal of fsmily to new domicile, purchasa of homc, rtc.) ~
F
~ ~ 5
i
Entering children in school; Homestead Exemption: ~
F
' ~
~r
~
~
. ST LUCIE C~UHTr FLA
• ROCEA pp~t~~s
CIERK CtitCtlfF CQURt
. RECORO vErU s~p
. - ,~~~,,,1~ , ~
03 py l,~ ~
I FURTHER CERTIFY that 1 will register at my local address when the registration baaks reopen, and
comply with all other requirements of a Iegat resident of tl~is St:ite.
I FURTHER CERTIFY that I havc no i~~te~~t~on to rcturn to my forn~er domicile, and I intend to remain in
~i ~ --,L~ c~ St . Lucie County,
Florida, permanently. (c'`f~ ~ '
~ . ~ , - ~ ~i ~ft ~ `l~' `r1/Nr~ ~
~ . F:- . ~ (Name)
_ k: - .
_ , . • . - •
~ ~ ~ ~ - ame
~ . .1 - ~
; /l
_ ~1'~i".•
Swbrn ar~ su~~,,~ rd betore me this I%' _ day of zng a ress
•.r~ . .
11et` -
_ A. n. ~ ~_Z~. ~~o yl~ ~c.~c~-,.~
R R POITRAS CLERK CIRCUIT COURT ~~;s.f y,~~LL. ~ 31/,5;,2,
_ . . _ ~.t~-
. -
Deputy Clerk -
(To t?c cxetuted in duplicalt anJ oti,:inal f~l. J acith ('Irrk ('~rauil Courl. an~ dupli.~tc with Tra Aucswr)
0~~~~
„
_ ~ . _ . .