HomeMy WebLinkAbout2598 .
Declaration of Domi~ile and Citizenship ~
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2'~4636 ~
TO THE STATE ANU COUNTY TAX ASSESSOR, .
ST. LUCIE _ COUNTY, FLORIUA: ~
This is my decla~ation of Domicile and Citizenship in the State af Ftorida that I am iiling this day in
accordance, and in conformity with Section 22Z.17, Florida Statutes. ~ ~
1 was formeriy a Icgal resident af - and I
(c~ey~. (se.~e)
resided at ..~~i~~~-!,r ' l~'-~ ~ . Ho ~?er, 1 h ve changed my domicile to
(Strtet snd mber) / f~~G, ~j
and am and have bccr. a bona fide resident o the State of Florida since day of
/ , 19.7~ , and 1 reside at 7
(S1r`et and Numbet)
. , - t..~ County, Florida,
~ (c~iy) -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~
(lnseri here sny pntinent facts, such u sale oi preperty or business, or relinquithment ot employment st former
domic~le, removal oi tamily to oew domicilr. purchase ot home, ctc.)
ENTERING CHILDREN IN SCHOOL: n. HOMESTEAD EXCMPTION: a
If entering chiZdren in school,
please list their names: -
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~l~~.-~--~' = ~ ~
2`7~636
fILED tkL' u~C~RDEO ~
ST. IUC~C G6UN1Y FU.
k:~~~ ~ :F?RAS
CLE~~~ G i,:l~+ COURT
ocr.~r'. -t[^~--
FEe !3 li ~z~N'7~, -
yp~~~
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! - ~ -
~ cal dress when the re 'stration books reo en and
t I FURTHER CERTIFY that I will reg~ster at my lo ad gi P,
f comply with ali other requirements of a Icgal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my former dvmicile, and I intend to remain in
. .
~ ST. LUCIE County,
~ ' '
F orida,•perr7nanently. (c~rY~ .
! , :.rt'i•
` : ir;:
! - ' ~ '
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I . .r ' -
I
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; S~rbr~;4o;~ndsui~scribed before me this day of
` ~ ::o~ 7~~ ~
; . ~
t ~ A. D. 19~. ~F~YL ~
, - ~
~ _ J
~ ROGER ~ POITRAS ~ CLRK GIRGUTT CO~t~ , Florida
E
~ By Deputy Clerk
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i (To be execufed in duplicate and oriRinal tileJ weth Cictk Citcuit Courl, and duplicate wilh Tax Assessot)
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