HomeMy WebLinkAbout0289 Declaration of Domicile and Citizensn~p
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1 U TNG STATE ANU C'OUN7'Y TAX ASSESSOR,
ST. LUCI~ _ COUNTY, FLORIDA: '
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71iis is tny drelaratian of Domicilc and Citizcnship in thc Statc of Florida that 1 am filing this day in '
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accordancc, and in conformity with Section 222.17, Florida Statutcs. ~
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1 was formerly a legal resident of , ~v E~- and I
(cilr) (stace -
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r~ sidcd at _ ~~:;1 I'~~ y.~r.~ . Howcver, I have changed my domicile to `
(5treet and Numbrr) ~
and am and havc been a bona fide residcnt of the State of Florida since day of ~
~ 9_r~, f~~,~ s/~i- ~
, r^ arid I reside at T ~ k'~ ~ S
~ (Street and Number) ~
_ " ~ .L'? ~ , -S .r .~.1L_G'_.,' ~ County, Flocida, ~
(c~iy) •
and this statement is to be taken as my declaration of citizenship, actua! legal residence and domicile in the State >
of Florida. '
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(Inurt here any pertinr~t facts, sucA as sale of properiy or business, or relinquishment ot employment at fotmer }
domicile, removal of tamily to new domicile, purchase of home, etc.) ?
ENTERING CHILDREN IN SCHOOL: 3~. HOMESTEAD EX~MPTION; a
If entering children in school, i
please Iist their names:
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UL"' !1~"~-~ n:.~- 2~s~.a~s
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J.C;' /~I~ _ lFJ ~Y? ~ FItED A':~ ~EC ~:~UfD
ST.IUCiI ;,J!,~kTY FLA.
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I FURTHER CERTIFY that 1 wiil register at my local address when the registration books reopen, and r
comply w~h all other requirements ~f a legal resident of this State. -
1 FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in =
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~ ST. LUCIE , County, : ~
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Florida, permanently.
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Swojii't~~an~-~sua,scribed before me this day of ,
.r••'to . 74 ~ -
~~-'a-~:,~ A.D.19 . '
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RlJGER POIT S~ CI.~RIt CIR~UIT_~QUBT~ , Florida ~
By ~~-d-~-~ ~ Deputy Clerk =
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(To be e:eculed i~ duplicate and onKinal filrJ with Clerk Circuit Court, and duplicale with Tax Assessot)
' ~_':t 224 ~A~E 288
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