HomeMy WebLinkAbout0841 Declaration of Domicite and Citizenship ~
. t
TO THE STATt: ANU COUN1'Y TAX ASSESSOR,
ST. LUCIE 2~6`35
_ _ COUNTY, FLORIDA: •
Tl~is is my clccldration of Domicile and Citizenship in the State of Florida that 1 am filing tliis day in
accontance, and in conformity with Section 22?.17, Florida Statutes. '
1 was formerly a legal resident of ~~a~ C~ and 1 ~
(citr) ' (state)
resided at ~N~~- • : However, 1 have changed my domicile to
(Street aad Number)
and am and have been a bona tide resident of the State of Florida since 2 - day of "
~ ~ ~o ~3 1?l.~c ~A c~'.
1~r Q C~ , 19~, and 1 residc at -
(Street and Number)
~0~1' ~1 . ~V C-1
L, , ~ St. Lucie County, Florida,
(c~iy)
and this statement is to be taken as my declaration of citizenship, actual lega? residence and domicile in the State
of Florida. .
(insett hcre any perlinent fxts, such u sale of ptoperty or busincss, ot relinquishment oi employment at formet ~
domic~7e, removsl of familr to new domicile. purchase of home, etc.)
OL ' HOMESTEAD EXEMPTION:
ENTERING CHILDREN IN SCHO t ~
If entering children in school,
please list their names:
ER?~ ~A~L LEd~r~c~p ~
~D o~~t.- ~ ~ ~~~rh ' ` .
flIEU :ECU~DEO f
ST,LUC~E CtlU~ltlf FI.A.
RG~;~ ?J~~AAS
CLE~? ••..J~~ COURT ,
9F~~F~ Y--
M~'[6 10 3oAM'1~1
i ~ '
i
~
~
~
' 2'7'~'635 _
I FURTHER CERTIFY that I 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 1 have no intention to return to my former domicile, and I intend to remain in
ST. LUCIE
~O~'r LU C i , , County,
~ ~c~~r)
Florid~,.permanently,.~
; •Q ~U 1' ~C'. '
: ~i;
~ ';i-,
_ Ci ~•E'~ ; _
_ - ' ~ "
~ ' ;
;~y ' ~ ~ , . .
~ 'n~ . ~i~ _
~ . : ti - S IGNA'TIIRE
~ 'i.,.~'~.
Swo,~rfCtaaii~'~i6setilied:tief~0i`~ me this day of
~ r..:~, ~ ~4 3og ~c,~~ ~
~ ~,~,.s,:.. -
. ll7G~..~ , A.D. 19
i in ress
ROGER POITRAS, CLERK C RCUIT COURT s'~', ~uC J~~ , Florida
e ut Clerk ~
_ By p v a~ 225 ~uf
(To be ezec eJ in duplicale ar?d uri~inrl tiled wiil~ Clcrk Circuit Courl, and Juplicate wilh Taz Assessor)
•
"1 r~
. _ - ~ ~
£ , ' ~rs -
r~ ~ ~ r;`~ ~y ss~~ ^ ~ :
.
- _v .v _ ~