HomeMy WebLinkAbout0466 "1 ~
Declaration of Domicile and Citizenship ;
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10 7't!E STATt: AND CUUNTY TAX ASSE:SSOR, . 275235 ~
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ST. LUCIE i t
_ GOUN7'Y, FLORIDA:
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Tltis is my cleclaration of Domicilc and Citizcnship in thc Statc of Florida tl~at t sm ieling tnis day in j i
~.rordance, and in conformity with Seclion 222.17, Ftorida Statutes. - Y
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1 was formerly a lrgal residcnt of _ r'•'~~.
, and I
(citr) (state) ; ' 3
r~: sided at G i? . However, 1 have changed my domicile to
(St~eet and fVumbrr)
:~nd am a~~d have becn a bona Cdc residcnt of the State o1' Florida since ~ ~ day of
i
, l 9~, and 1 reside at Z Z 1 D~ S. 1~ S'~ ~ -
(Stteet and Number)
S/'~ L ~l G~.r~.
- ~T . County, Florida, ~ f
(cicr) •
.k
a~~d this statement is to be taken as my declaration of citizcnship, actual legal residence and domicile in the State :
c~f Florida. F'
(insert here any pr~linent facts, such u sale ot p~operty or business, or ~elinquishment of employment at tormer
domicile, remoral of family to oe» domicile, pwchasr oi home, etc.)
ENTERING CHILDREN IN SCNOOL: HOMESTEAD EX~MPTIO:~:
If entering children in school, .
please list their names: =
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Svz' Arv~vfz ~~i9~~ -
FILED a!+= 'F~~`r.UED
st ~uc: _ ~ ~uN~a~ •
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S~9~,~. or- flo•~h.. s AN'1~1
F~a 12 ?i s
~~LiN~ t!~ Sr1 d.l= ~Dl3 ~/3
1~v/~d~9s~. oi= ~o ~ c~ o.v S. ~51 2'~5235 -
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1 FURTHER CERTIFY that I wiSl register at my iocat address when the registration books reopen, and
comply with all other requirements ef a iegal resident of this State.
1 FURTHER CERTtFY that I have no intention to return to my tormer domicile, and I intend to remain in ~ ~
/7 ~ ~~LGiE. ST . LUC IE ~ ~
, County,
Florida, permanently. (c«rl , - `
_
i~ e d ~ a~ e„
Sworn to~~ifictsittSSci-ibed before me this 2~" day of =
- • , A.D. 19
7~.'
_ . ~ .
~ Florida
-~t(~GE R PQ~:TRA~
; C~.E RK Bc_~_I_T_~oUBT.- ~
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ti
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BY'~'~'r• ' c, Deputy Clerk ~
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(To be eae led in duplicate and uriginai fitrd with Ctrrk Circuit Coutt, and dupiicalr with Tsz /lssessor)
~ 224 ~A~E 465
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