HomeMy WebLinkAbout1283 Declaration of Dor~icile and Citizenship '
"1'O TI1l: STATI: AND COUNTY ~'AX ASSI:SSOR,
_ ST . LUCIE COUN7'Y, F1.ORIQA: i~i~! SSa~~
71iis is my clcclaration of Uoinicilc and Citizenship in thc Statc of Florida that ! am ~1ing this day in
accordancc, and in conforniity with Section 222.17, Florida Statutcs. ~
1 was formerly a legal resident of ~T f/Q //d ~ , ~ v and 1
(c~~r) (s~a«~
residcd at ~~'/F T~Gr d D~ d ~o d ~
However, I have changed my domicile to
(Street and Number)
aitd am and have been a bona fide resident of the State of Florida since day ot
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~F ~""~-~vl ~3~~' , t9 , and I resid~ at ~/1' G ~~1 .t/ ~o d T
(Stteel and NumAe~)
~d.~ i / ~P~% , ~7- L d County, Florida, -
~c~~y~ -
aRd this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(It?seri Aere any prrtinent facls, such as sale of property or business, or ~elinquishment ot empioyment at former
domicJe. removat of family to new domicite, purchase ot home, etc.)
ENTERI*IG CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTIO:V: ~
If entering children in school,
please list their names:
~T
•a=
F~_~ ~ r ~ = :.~,RDED ~ .
SL ~'J~? ::~"i/iT FLA. ~
f::. --aS l
• ~i r r • - rnuRT ~
FE8 2a L 03 ~'N ~7~
S,
2'~5830 ~i
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i I FURTHER CERTIFY that I will rrgister at my local address whcn the registration baoks reopen, and
' compiy with all other requirements ef a legal resident of this State.
~
! I FURTI{ER CERTtFY that 1 have no intention to retiirn to my former domicile, and I intcnd to remain in
i
' ~ ST. LUCIE
i f
t~ % j`;
F~ c c , , COUnty, -
Florida, ~ermanently. ~ `
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c~~j'~ G~/
J~, ~ • • 'C~~~~.~; ' " IV1~IN i _
~j' ' t_. C~ ~t s t Q v e /7 ~ e KQ so T(> i, fi
V / y i ~ • ~
Svirbi~~~'~,,
~~~anc~'sul~sen~bc~~ before me this~~~day of - :
~,F~ . i< V , , /~lJ ~ ~/f ~ ~ /V ~J C~//~ r- (
'~~,~rP"~~ A.D. 19_ 74 . .
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ROGERI POITRA^S
GLERK ~LIIZ~QIIBT,- ~ J /r ~'~'r , Florida ; :
By ~ Deputy Clerk
(To be uecuted in duplicale anJ originrl tiled K•ith Clerk Circuit Coutt, and duplicate with Tax Assessot)
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