HomeMy WebLinkAbout0227 Declaration of Domicile and Citi~zenship
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7O1'tU: STATl: ANU COUNTti' TA~ ASSl:SSOlt, ~
ST._LUCIE COUNTY, i~LOR1llA:
This is ~ity drelaration of 1)omicilc and Citizcnship in Ihc St.~te of Florida that l am filing lhis day in
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:~rcordancc, :~nd in conformity with Section ???.17, Florida Stahitrs.
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I was formerly a legal resident of ~ .rl ~ - ~
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i<SI(~C(~ a!~ _~__~L`__ L!!. .~C"./^n~^,t"~ b {~%~i- , /
~ " ~ ~ ~ ~ Nowever, I have changed my domicile to ~
(Street and Number) ~ ~
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and am and have bee~~ a bona fidc resident of the Statc of Florida since .t_ day of ~
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t' , 19~__T, and 1 residc at ~
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- -{Strcel and Numbet)
~ ~ ~4.0 ~ J'.~~ ~ County, Fiorida, ~
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and this statement is to be taken as my declaration of citiTCnsi~ip, actual legal residence and domicile in the State
of Florida.
(Insert here any prrtinrnt facts, sucA as sale ot property or businecs, or telinyuist~ment of employment at fotmet
domicile, temo~al of famiiy to oea• domicile, purchase ot home, rtc.)
ENTERI*iG CHILDREN IN SCHOOL: HOMESTEAD EXErtPTION:
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If entering children in school,
please lis~ their names:
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2'7:iQ~.9 -
F~L4.t • y`~ED _
ST. ~ ~ :N1 Y rl.A.
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F~8 Zo ~ 22 PM ~~a ~L ~
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I FURTHER CERTIFY that I will register at my locat address when ihe registration books reopen, and ~
comply with atl ott~er requirements ef a legal resident of this State. i
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I FURTHER CERTIFY that,~ have no iniention to return to my former domicite, and I intend to remain in
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1 t_ ~ ~ ST. LUCIE County, -
Florida, perma
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ntly. <c~tr~ , '
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Swoi'r?.to a•sub~srnbed before me ihis " day of y~ ~ _
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LC.f~.c~~ A.D. 19 74 .
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ROGER POITRr~S,`~gg~Ig~i~IZ.~pugZ_ ~ ~ %'=r-~ , I'lorida
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BY ""''4~~ Deputy Clerk
(To be execuled in duplicate and ori~:inat f~IrJ Nitb Clerk CircuK ['r~url, and duplicate Milh Tat /~.iseswr)
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