HomeMy WebLinkAbout1093 . Declaration of Qomicile and Citizenship
TO TNG STATE ANU COUtiTY TAX ASSL•SSUR, i~~8~~
~ST. LUCIE COUNTY, FL4RIDA:
'[liis is my declaration of Domicife and Citizenship in the State of Florida that 1 am filing this day in
accorciance, and in conformity with Section 222.17, Florida Statutes.
1 was farmerly a legal resident of H v.v ~~"ti ~%o•? , t- , ~/b l~? ~--~o K~~ and I
~ (citr) ~.te) , _
resided at Z d/ i3A•~ r+ v-c . However, 1 have changed my domicile to
(Street and Numbe~)
and am and have been a bona fide residcnt of the State of Florida since ~d day of
~ ~J.~.c ~ ~ 19~y and I reside at / ~ 7 5 . C • . ~ ~P W i? ~ v ~ _ .
' . (Stteet sad Number)
/'Q,f ~ ~ T, ~ ~ ~ ; • _ ~ St . Lucie County, Florida,3fy~
(Citr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
(Insert here sny pertinent facts, such as sale of property or business, or relinquishment of employment at tormer
danic~e. temoral oi family to new domicile, purchase of hume, ete.)
ENTERING CHILDREid IN SCHOOL: HOMESTEAD EXEMPTION: _
If entering children in school, L=1
please list their names:
f~~fe r.y= ~~~oROEo
st ~uc ; ~ ~s:~~sY Ft~.
- Bu~:" :;i?RRS ~
CIE~~ . .Uti iOURT
=crnc :f~ •~D
M~ ~t i i 24 AM'?~
i •
I ~
2'7'~78~: ~
;
~
I FURTHER CERTIFY that I will register at my locat address when the registration books reopen, and ;
comply with all other requirements of a legal resident ot this State.
~I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in ~
~'on % r T' L ~ L ~ ST. LUCIE , County,
Florida, permanently.
~ I~
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: ~ - S IGI~ATURE
~ . ~ ~ .
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~ ~Sb+orin~~o an~ ~db~ before me this day of
~ ~ • s ~s
~ ~ ~ - 74 . ~ 7~ ,s . c. ,C ~z w; -v ~e.~.
~ A. D. 19
~e";i i ing r.ess
_ j~-~~~~'(~~AS, CLER CIRCUIT COURT /~o z,- s%-.~.vc j 1 , F]_orida
; 3 ~F s
z_
Ly Deputy Clerk • "
(To be exe ed ia Juplkate anJ oriRinal fdrd with Ckrk Circuit Coutl, and duplicale vrith Tax Assesux)
~ooK225 ~~F1091 .
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