HomeMy WebLinkAbout1520 Decl~ratian of DQrnicil~ and Citi~enship ~
iO1~! 1!: S1'A"fl: AND ('OUN7'Y '1'AY ASSI:SSUIt, ~ 2~5~83
ST. LUCiE _ ~ c~uN7~Y, t~LnRIUA:
Tl~is is my drelaratiun of Domicilc and Citizcnship in thc State of Florid:i that 1 am filing this day in
;~~cor~lancc, and in conformity witli Scction ?22.17, !~lorida Statutcs. '
~
1 was formerly a lega) residei~t of r'!' ~'P ~'9 ~ ,~~iD 'v AJ'~ and I -
(ci~r) (sta~e) ~
~
t~Sl(IC(I ~t ~~r'yti'~'- /e% ml1 r/V However, 1 have changed my c:omicile to ;
(Sireet and Nurnber) f
and am and have becn a bona fide resident of the State of F'lorida since ~S~ day of t
~
___~A'`' , 19~~ and I reside at ~~'~'~E pE ~GC cN ~
(St~eet and Number) ~
~'T ~l~i U/t C' t` ~ ~ 7`' ~ s7 C i c~ t
County, Florida, ~
(c~~Y~ ~
arid this statement is io bc taken as my declaration of ciiizensl~ip, actual fegal residence and domicile in the State
of Florida. -
(Insert here any pertinent tacls, such u sale of property or business, or relinyuishment of employment at tormer
domicile, ~emova~ of family to ~ew domicite, pu~chsse ot home, ele.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school, ~
please list their names: ~
~ ~L1~ ~~l C s ~
5 ~c U • -
fIL~O Rti^ FivJs~OEO ,
ST_ LSlC~C ~,3L'11TY fl,A.
P.aG~ ~ ; i '~~S ~
CLEi•.! . ;i,T Ct~URT
Qf~L~Rf v=i ~ .E,~
M~ut ~ IC s2 AM'7~1 ti=
2'75983 `
I FURTHER CERTIFY that I will register at my local address when the rcgistration books reopen, and -
! comply with all other requirements of a Iegal resident of this State.
~ I FURTIiER CERTIFY that I have no intention to retum to my former domicile, and I intend to remain in
~p,p~e ~;~c ~ ST. LUCIC ~ ~
, County,
1=lorida, permancntly.
~l .
G.
r s~a ?ri~4S~ -
S IGi~ATURE - 1
. r.
Sworn to ~itic~;su~erj~ec~ beforc me this day of -
-
•,,tj~;~ I 74 `
-~*ylll~`_ A.ll. 19------
- - t=-==~- ~ "
, ; . . i ing ress s
R. ~L ~Y`OITRAS r;C~.~RK CT CUIT COURT t
_ , , - , Florida
. s
By J=,` .,~r~ ~ ~ eput~y ~Cl erk
~ , e . , ; ~
, ~ ~ ;
' (To be tx lad in dupticale and ~~ri~ inal tiled wilh Clrrk Circuit Cuurl, and Juplirate wilh Tax Assessor) 4:
~ ~i
r ~ 224 PAGE ~.5~.9 t'
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