HomeMy WebLinkAbout0855 Declaration of Domicit~ and C:~tizensn~p ~
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_
TO TlIE STATE AND COUNTY TAX ASSGSSOIt,
__ST. LUCIE _ COUNTY, ~LORIDA: ~~649
This is my dcclaration of
Domicilc and Citizcnsl~ip in the Statc of Florida that 1 am ~ling this day in
accorclance, and in conformity with Scction 222.17, Florida Statutcs.
;
1 was formerly a legal resident of •/y'~~z~ , -U~~~ and 1
(p• - (state)
~ ~ ~ . However, 1 have changed my domicile to
residcd at _
o.~..~ (Sir t s Numlxr)
and am and have bcen a bona (ide nsident of the State of Florida since day of
~ -
`'~a/'f , 19 ~3 ~ and 1 reside at 3`~
. (Sueet and Number)
~ _ ' St . Lucie County, Florida,
t
(citr)
and this statement is to be taken as my dcclaration of citizenship, actual legal residence and domicile in the State
of Florida. . .
(Insert here any pertinent facts, sueh as sate of property or business, or relinquishment of employmenl at tormer
domic~7e. removsl of family to new domicile, purchase of home, etc.)
OL• ' HOMESTEAD EXEr1PTI0N: ~
ENTERING CHILDREN ~N SCHO .
If entering children in school, ~---1
please list their names:
~~t~ o ~tcoROE
. SZ.lO~iti_:.at3!Ij~' fl~ ~
RQ~i'r.."-~:~ql?S
~~EQK ,^.UiI COURT
n=~r=.,^ Vt ~ -iE4
3
~ ~ ~6 !i o7 AN'Z'~ - i
_ ,
; 2'7"7649 4
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I FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, and
comply with all other requirements of a legal residcnt of this State. _
1 FURTHCR CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
ST. LUCIE ~
~j~ ~y~ ~ , County, ~
Florida, perrr~anently. tc~~r) ,
. i
~~~ifu~~.~~~~,.. ~ ' i
.•'n C;ul1` L, ;
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~fl ~•~,~'s~'~z~;+..?Ar~` i
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~ =~~tt}.~c~~nd si ~,qtied before me this ~ day of I
~ ~
~ . y,.., • .,L~ 74 . .
~ ~ F Q A. U. 19__. ~ 3~
. ~~aiTi
-~~g"~'d'dre
~ _
~ ROGER POITRAS, CLERK CIRCUIT COURT ~,1~~ , Florida
~ .
~ ny Dep~ty Clerk
~
(To t~ eaec d in Juplic•rle and oriRinal fi1eJ with Clerk Circuit Cnurl, anJ Jupticale witl~ Tax Asseswr) -
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~ - ~o~K 225 0~ 8~
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