HomeMy WebLinkAbout1370 Declaration of Domicile and G~tizens~rp
-ro -r~it: s~t-nTC nrra covN~'Y TAX ASSI:SSOR, 2'~'5891
ST. LUCIE _ COUNTY, 1~LORIUA: ~
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Tliis is my dcclaration of Domiciic and Citizcnsliip in th~ Statc of Flo~ida •that 1 am filing Ihis day in ;
accordancc, and in conformity with Section 2~2.17, Florida Statutrs. ~
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1 was fornicrly a Icgal resident of , ~ i_~~ _ _ and 1
{c~~y~ ~s~a~~)
r~sided a[ ~ ~~-~i~ • . However, I have changed my domicilc to
~ Streei and Numbrr) '
and am and have been a baia ~dc resident of the State of Florida since ~~~G~ ,~~ay ot'
19 and I residc at ~ Q'~
~
_ (Street a um r)
. - "~~~~-~1--*- County, Flarida,
. (c~~y) - -
a~zd this statement is to be taken as my deciaration of citizenship, actua! legal residence and domicilc in the State
of Florida. -
(insert here any pertinent lacts, such as sale ot properly or business, or relinquishment of employment at former ~
domicile~ removal uf family to new domicile, purchase ot home, rtc.) t
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ENTERIrIG CHILDREN IN SCHOOL: HOMESTEAD EXErtPTION: a
,
If entering children in school, !
please list their n es: ~
~ #
~ L _ r
FIIEG ~tEG:: ~DEO
ST.LtICi£ ~;JUViY fU.
P.~:~; : '~AS `
CI E~~ ~t • .~ti COURT <
or~re- - . -
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MaR { l( io AH'7~ f
2'~5891 = .
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I FURTHER CERTIFY thai 1 wi11 register at my local address when the registration books reopen, and
comply wiih al! other requirements ef a legal resident of this State.
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I FURTHER CERTIFx that I have no intention to return to my former domicile, and I intend to remain in
r:~fZC ~T cC~~ . ST . LUC IE Cotfnt y,
,
Florida, permanently. «"y~ `
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Swore~jb;'arti~'s~, `''bed Sefore me this ~ day of ~i 1 ~ ~
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. A.D. 19 74 .
ROGER POITRA~~., CI.ERK_ ' QUR~ 7'~~-~- , rlorida +
By Deputy Clerk
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(To be ~ ecuted in Juplicale and original filyd with f'lerk Circuit Courl, and duplicate w~th 'Taa Assessw)
t 224 FacE1~69 ~
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