HomeMy WebLinkAbout0309 Dectaratioi~ of Domicile and Citiz~nship '
TO TNL' STATG ANQ COUN7'Y TAX ASSI:SSOIt,
ST. LUCIE _ COUNTY, fLORIUA: 4
This is my dcclaration of Domicilc and Citizcnship in the Statc af Florida that I am Ciling this day in
accorclance, and in confonnity with Scction 222.1 Florida Statutes. ,
1 was formerly a legal resident of `'~N ^ and 1 ~
~ ~ tcitr) (state)
resided at ~ . However, I have changed my domicile to
(St~eet and Number) ~
and am and have bcen a bona fide resident , of the State of Florida since day of
, 19~y and 1 reside at .
~ , (Street and Number)
' St. Lucie County, Florida,
.
- (n~r)
and tliis statement is to be taken as my declaration of citizensliip, actual legal residence and domicile in the State
of Florida. • ~
(Insert here any pertinont facts, such u ssle of property or business, or relinquish~eent of employment at tormer
domicile. removal ut famity to new domicile, purchase uf home, etc.)
• • HOMES7'EAD EXEMPTION:
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names:
FILEQ SHG PECORDEO
- ST. LUCi~ ;O~HTY FIA.
P,GCE~. r^~t?AAS
CIERK C!~Ctili COURT `
. aECOF.~; L'E~ :*"~EJ
; ' _ MIaR ~0 II s3 aM'~~1 ~
;
r
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;
~ ~ ~
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I FURTI~ER CERTIFY that 1 will register at my local address when the_registration books reopen, and ~
comply with all other requirements of a legal resident of this State. .
I FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in
P., ~u~~, _ ST. LUCIE , CountY, i
~ permai't~ntly. (c~~r~ ~
~ Flor~l~~,' , . .
~ :t :,.i r l
~ i ^ t~.
~ _ 3~'' " ~3;~
k~ . , . ,GA~ , ~
~ , • ~
~ ~ ~i ;s,~j SIGI~ATURE
• ~ ~ '
~ ' . 2 ~
~ ~~~wp~j
f~~ ~y~~r~bed before me this day of
„ ,s ,:`4r .
. i ~ • 74 / ~ ~os
~ ~ ~U .
A.D. 19
i ing ress
ROGER POITRAS, CLERK CI. UIT COURT Florida
~
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gy'. eputy Clerk ' f
~ (Tu be rx Ied in Juplicale •rnJ otiFinal (ilyd wilh Clrrk Circuif Cuutt, anJ duplicale wtilh Tate Assessnr)
. ac~x 225 P~cc 30~ ~
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