HomeMy WebLinkAbout0854 Declarat~n of Dom~cii~ and ~;itiz~n~n~;~
7'O TNI: STATE ANU COUNTY "1'AX A5SESSOR, '2~ Isl~B
ST. LUCIE _ COUNTY, f=LOR1DA:
Tl~is is my declaration of Domicilc and Citizenship in the State of Florida thai 1 am filing this day in
accordancc, and in conformity with Scction 2?2.17, F~oricla Statutcs.
1 was formcrly a l~~gal rrsident of E vE ~ A N~ ~ Of~io and I
~ci~r~ (s~.~e)
resided at ~L ~,_,C- ~ES7~ / 7~ ~ ST. . Nowever, I 1?ave changed my domicile to
(Stteet and Numbe~)
and am and have b~~;n a bona fide resident of the State of Clorida since ~ 3~=~ day of
M ~ ti° C 1y , 19 7`f and 1 reside at _3 d O 7~. 57' ,~e~
(Street snd NumAer)
~Q,toT' /djE,(~C F , ' St. Lucie County, Florida,
(c~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the 3tate
of Florida. •
(Inserl here any pertinen! facts, such as sale ot propertY ~ business. or telinquishmeM of employment at tormer
domicile, remo~al ot family to new domicile, purchase of home, etc.)
• • HOME STEAD EXEMPTION : ~
ENTERING CHILDREN IN SCNOOL. ~
If entering children in school,
please list their names:
~r/, ~.d C oL E- .
,~i, c Ta R~ G o,C E -
Fi<<o ~ :.c~roEo
~'o ,y ~ T' N c F 1. C o L~ _ sf. ~uc~~ : ~uNTT FtA,
RGCE " ~ i r~AS
c o L F c~ couRt
/~1 ~ N~ L~ F,L- Q:r~~.;: U
?
Mat [5 ii o3 AH'1~1
`
2'~648
4
~
{
- ~ .
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.
1 FURTHER CERTIFY that 1 have no intention to return to my formcr domicile, and 1 intend to remain in
{
~ r c~ ST . LUC IE , County, `
(c~ty) ~ ~
Florida, pet~i,ei~'t'ty;;:, ~
: •
-
•
- -
.J ~ .
- ~ . • f (,(/i / / / 4 l'vf l o / C
• SIGNq RE
. _ •
-
~ Sworn to and subscnbed b+~fo~:, me this _ 2~ day of ~
~ ~ ~
~ A.D. 19 74 " . °
i zr g re s s '
~ ROGER POI'fR~'.S, CLE::K CIPCUIT COUR1' , Florida
gyM C Deputy Cl.er'K • _
V t
(To br e~ecuted in duplicale ~nd oriKinrl f~1eJ with ('Irrk Circuit Courl, anJ duplicate with Taa Asxssot)
BOOR ~~5 PIKE
- ,
. . w r
~ .~.w
~ ;A 4
~~u ,~~,Y~:;.~~~,~,~~ ° ss
- ~
,y
1 J'~~' i. ~
'"a~^"~+'~ ~
w-i~'.-.:%-°
~ _ ~
F'
, w. . ~x^~ _ , .m....._ ~a~ .