HomeMy WebLinkAbout0958 Deciaration of Dor~icile and Citizenship =
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2'75550 ~ ~
TO TH[i STATE AND COUNTY TAX ASSESSOR, . ~
ST. LUCIE _ COUNTY, FLORIllA: ~
This is my dcclaration of Domicile and Citizenship in thc State of Florida that t am filing this day in
accordance, and in conformity wilh ~cction 222.17, Florida Statutes. '
1 was formerly a legal resident of oo k~- , ~~~.tJ ( d 2~_ and 1 ~
(Cilr) (stste) !
r~sided at ~~a 7-, ~l vGn . However, 1 have changed my domicile to !
• (Slreet and Numbe~) ~ F
and am and have been a bona fide resident of the Statc of Florida since ' day of ~
` ~2 , y R t
~~~c ei'~ b'~ ~ , 19_ and I reside at ~ RD S~ G~
_ ~O /l ~ L ! °l_ ' ~t_ ~ ~ G ~ S~ t and N mber)
°~T County, Florida,
~c~~y~ -
and this statement is to be talcen as my dectaration of citizens~~ip, actual legal residence and domicile in the State
of Florida.
(Inseri here sny pertinent facts, such u sale of property or business, or relinquishment of employment at former
domicile~ removai ot famity to new domicile, purchue oi home, etc.)
ENTERING CHILDREN IN SCHOOL: NOMESTEAD EX~MPTION: ~
If entering children in school, _ 2,~5~~~
please list their names: _
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F!L£d -SF~~kQED
ST.FL~ . ~:?t3R~as LA_ .
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I FURTHER CERTIFY that 1 will register at my local address when the registration books rcopen, and
comply with all other requirements ef a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my farmer domicile, and I intend to remain in
l~o t' t• ~ v ~ i e_ ST. LUCIE _
, County, .
Flciiida, p~itri~nently. tc~tr~ ' _
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Sworn.to~and~subscribed before me this day of .
.~3 a ~l C~
~ A. D. 19__Z4_. `
/ _ / S
ROGER POIT . C.FRK C R. l7T COIIRT ~ , Flor' a
. ~s
By ~c~¢c~-~ Deputy Clerk
(To be executed in dupiicate anJ urigi~al filed with Clerk Circuit Court, and Jupticate vrith Tsx Asxstor)
- F 2~4 PACE 95~
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