HomeMy WebLinkAbout1225 Declaration of Domicile and Citizen~hip
7'O TtiG STATI~ ANU COUNTY TAX ASSESSOR, ~~~:fO1, ~
_ ST. LUCIE _ COUNTY, FLORIDA:
71~is is my drelaration of Domicile and Citizcnship in the State of florida that 1 am filing this day in
accordance, and in confomiity with Section 222.17, Florida Statutcs.
1 was formerly a legal resident of 1~~~ J'-~` , and 1
. . (cilr) . (state)
recided at G u s~ ~ . However, I have changed my domicile to
(Slreet snd Number)
and am and have been a bona fide msident ,of the State uf Florida since day of
, 19.~., and 1 reside at - (1~l G~~~ u~~ -
- (Street and Number)
• !L~ ' St. Lucie County, Florida,
,
(citr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. -
(Insert Aere any pettinenl fxts, such u sate of propertr or businest, or ~elinquishment of employment at former
domicDe. ~emoval of family to new domicile, purchase of home, etc.)
N SCHOOL: ' HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN I ~
If entering children in school,
please list their names:
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1 FURTHER CERTIFY that I will register at my local a~dress when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in ~
L
ST. LUCIE ~
~ ~r9 . c ~ , County,
Florida, permanently. cc~`r~ -l
- ~ , ~ ,
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F ` _ Jy:; ~ ~L- C L'`'
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~ _ ~ ' SIGIIATURE ~
~ '~Sy?,ojh~to~~apd~lib~bed before me th day of '
~ ' ~ c p~:•~,t` - t,~ 74 ~L ,1~
Z~~~-
A. D. I 9--. ' -
~ ~a ing re s s
ROGER OITRAS, CLER CI CUIT COURT ~ ` Florida
~ _ , ~-i c ~
~ ~r
~ ny \ , ~ c.~ eputy Cler.k ~ ~25 v~CE1~3~3
BOGA iG,
~ (Tu be executed in Juplicale and ntiginal filed with Clerk Circuit Cnurt, and duplKate wilh Tax Asxsxx)
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