HomeMy WebLinkAbout2983 . ~
Declaration of Domicil~ and Citizenship
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TO Ttil: STATE AND COUNTY TAX ASSL:SSOR, . 2~4~Q8
^ ST. LUCIE _ COUNTY, FLORIDA:
Ti~is is my dcclaratic~n of Qomicile and Citizcnship in thc Statc of riorida that 1 am filing this day in
accordance, and in conforniity with Section 222.1?, Florida Statutcs.
I was formerly a legal resident of `-'v~/ T~ O/~~ , V/~ and I
(citr) - (Stste)
resided at O, ~Q.r~'-_.~0.~ . However, 1 have changed my domicile to
(Stteet and Number)
and am and have been a bona Cde resident of the State of Florida since ~fl~ day of
-~,.1 , 19~2 and I reside at 1~~/~/%
l~.E'E Ol~T L OT ~~~5;~'
(Street and Number)
f~/\/.S~/U ~,~.AC~ ~O. ~0,~' /037, ~ • ~ [JC_ ~ ~ County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert here any pertinent facts, such as sale of property or business, or retinquishment of employment st former
damicile, ~emora! of family to new domiciie, purchase ot home, ete.)
ENTERING CHILDREN IN SCNOOL: n. NOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names:
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2'~4~0~ k
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' ST. tU':,: ...:UN~ T FlA.
F~_. -;AS
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Ff6 ly !li lb AM'?
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requiremcnts ef a tegal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
~~/l/~'1~~~ D(>T ~"T- , ST. LUCIE , County,
Florida, permanently. cc'"`) '
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SwQt1~?'.~ .a»~tli„~sCFibed before me this ~9 day of ~
E~~~"'~G ~ ~ ~ /O 3 ;
.;~'7,~.c_~tif,~ A.D. 19~. •
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ROGER IT~AS ~LERK CI~UIT~QII$~ , Florida
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By ~oY~~~` Deputy Clerk .
(To be executed in duplicale and origin~l filed N•ith Clerk Circuit Courl, and duplicate wilh Tax Assessot)
_ ~ ~:=i ~23 PA~~2983 - ~
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