HomeMy WebLinkAbout1095 Declaration of t3omicile and CitizenshEp
TO THI: STA1'G ANU COUNTY TAX ASSESSOR,
ST. LUCIE 2~~~'~ '
_ COUNTY, FI.ORIUA: ~
~
11~is is my dcclaration oP Domicile and Citizcnship in thc Statc of Florida that I am filing this day in t
accordancc, and in conformity with Section 222.17, Florida Statutcs. _ ~
r ~ C, ~
1 was formerly a Icgal resident of C ~ ~ and 1 ~
~~Y) (s~.~e) ~
resided at GG . However, 1 have changed my domicile to
(Street and Numbe~)
and am and have been a bona fide resident of the State of Florida since day of ;
. , ~
~ ~ L~ , 19~ ~ , and 1 reside at / ` ~ ~ T- #
• (Street aad Numbet)
~j'~~~~C~ ' 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 State
of Florida. . . - -
(Intert here anr pertinent tacts, such u sale ot pruperty or business, or relinquishment of employment at tormer ~ '
domicile, removal of familr to new domicile. purchau ot home, etc.)
REN IN SCHOOL: ' HOMESTEAD EXEMPTION:
ENTERING CHILD ~
If entering children in school,
please list their names:
~
~ K. yF~„a~ED ~
fil_Uf'•, ~-~~JNT'1 FLA• J` ~
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1 FURTHER CERTIFY that t wiq register at my local address when the registration books reopen, and
comply with all other requirements of a Icgal resident of this State. _
1 FURTHER C TIFY t I have no intention to return to my former domicile, and I intend to remain in s
- ST. LUCIE County, ~
,
Fiorida, pe~nti~,ently. cc~~r) - #
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~ Swotfi~o'~t~i.su~i$cribed before tnc this day of ~
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~ ~ ll~~~ ~ A. D. 19 74 . s~1 €
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ng Ad" re s s ~
ROGER POITRAS, CLERIt C. 'UIT COURT ~T /f~C~ ~ Florida #
~
~ gy c,~ ~:sty Clerk •
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(To be esec rJ i~~ dv~,t ~t• .nJ ori~in:d filyd ~~iU~ Clrrk Circuit Courl. and .luplicate wilh Tax Asseswt)
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