HomeMy WebLinkAbout1526 Declar~tian of Domicoie and Citizenship ~
ic~-rii~: s~~nTC nn~uc'OUN'1'Y 7'AX ASStssoK, ;~,75:~8,7
ST. LUCIE_ CUUNT~~, ~LOItlUA:
Tiiis is my drelaratian of Uomicilc and Citiz~~nship in thc Statc of Florida that 1 am filin~; this day in
:~rroraancc, and in conformity with Scction 222.17, Florida Statutcs. .
1 was fornicrly a lcgal resident of ~ ~7 S~ ~ and 1
~~r (state) ;
. ~
rt sidcd at ~ ' . Howcver, 1 havc changed my domicilc to ~
troet and NumAer) s
and am and have been a bona fide residcnt of the Statc of ~lorida since day of ;
rn~~~~ , 19_~, and 1 reside at ~ ~
( treet and Numbct)
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~ ~ C nty, Florida,
(ci~y~ • ~
a~id this statement is to be taken as my declaration of citizenship, acte~a! lega! residence and domicile in the State
of Florida.
(Insert here any pertinent Ixts, such u sale of propetty or Ausiness, or relinquishment of employme~t at fotmer .
domicile, remora) ot tamily to new domicile, purchase of hame, etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names;
~ 1 cl.~~l C9-aP A~~s
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FILEO ~~L~ YECUROEO - ~
ST. LUC~E ~UJHTY FLA. 1I~
RO~i"=. F i''RAS - -
CIERK C::+C+J~T COURT
?ECOR~ `I;P'=+E(}~„~~
Mlan ~I !I o~ AH'7~!
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I FURTHER CERTIFY that ~ will register at my local address when the registration books reopen, and
comply with all ofher requirements of a legal resident of this State.
` FURTHER CERTIFY that [ have no intention to return to my former domiciie, and I intend to remain in
~ ~~l ~ ST. LUCIE
~ _(l~.J~r ~ ~ ~ 1 , , County,
Florida, pcrmancntiy. ~
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~1, - ~t ` S IGI~iATURE
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Swo~ aanasubso~~ ~~bc~ore mc this day of -
;1~,j~ -m' .'f•-
74 / ~
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, , . ,•.f' i ing aress ~
; ••`$4 ~~~4~', CI.EKK CI CUIT COURT Flor da :
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IIy ~ eputy Clerk ~
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; V (To bc cx~ utcJ in dupl~cate -rnd ur~~:ii~.d fdrd ~cilh ('irrk Circuit Cuurt. anJ Jurlicate welh 7'ax Asscswr)
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' - r 224 FA~~1525 ~ ;
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