HomeMy WebLinkAbout2925 _ i
Decaaration of Domicile and Citizenship ~ ,
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"1'O THE STATE AND COUNTY TAX ASSESSOR, . ~
ST. LUCIE _ CQUNTY, FLORIDA: '
,
'iliis is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
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accordance, and in conformity with Section 222.17. Florida Statutes.
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1 was f ormerly a legal resident of L.~`~e _,~~C~ /L~ - v and 1
(Citr) (st.te)
resided at ~ . However, I have changed my domicile to
(Street and Numbet)
and am and have been a bona fide resident of the State of Florida since day of
;'Y i~~ , 19
~'y and 1 reside at ~ r~ F /v ~F h/ ~4 `~7 F~/f _ ~
(Street and NumAer)
, County, Florida,
(c~tr) - i
and this statement is.to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inseri hete any pertinent facts, such as sale of property or business, or relinquishment ot cmployment at [ormet
damic~7e, removal of lamily to new domicile, purcAase of home, etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names:
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FILfG Ah~ ?ECJR~EO-
ST. LUCt~ i;OUNTY F~A,
IiOC£~' F'v~TRAS
CIGRK C~ :CU1T COURT ~ ~
- RFGOf:= ~F.rc~ED~-`..,
FE618 i i 21 AN 'T~ .
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' I FURTHER CERTIFY that I will register at my iocal address when the registration books reopen, and _
; comply with all oc- .~r requirements ef a tegal resident of this State.
~ I FURTHER C;ERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~ ~ •
E /vc.e~t..c~ ST. LUCIE County,
,
Florida, permanently. - ~
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- Sviror -to ~ttd~s~ibei~:before me this day of ~ - ~
~~1 ^ ~
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` A.D. 19~~
ROGER P TSTT
~0~1~t~~ ~l.'f' ~='~'~-'~'.'./~~e~~-~ ~ Florida
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~ By a~+C~ Deputy Clerk
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(To be executed in duplicate and original fited with Clerk Circuit Court, ~nd dupiicate with Ta: Assessor)
• ~-r L~N~ P~CE 2925 i: