HomeMy WebLinkAbout1290 . Dectaratio~ a~ Qomic~te and Ci~iz~nst~i~
"I~U Tf1L• STATI: ANU LOUNTY TAX ASSI:SSUR,
ST. LUCIE _ cauNTV, E~[.o?zinn: 2~5~~
71~is is my Jrcl.uation of Uon~icilc and Citizrnship in thc St.~tc of i~lorida tliat 1 am filing this cl~y in
acconiancc, and in conforniity with Scctic~n 222.17, Florida Statutcs.
1 was formcrly a lcgal residcnt of _ ' y Q.rS and I -
( r) (stste)
resided at ~ n t- ~ . However, I have changed my domicile to
(Stteet and Numbcr)
and am and have bcen a bo~a lide resident of tlie State of Florida since day of >
_ c~ , 19__~, and 1 residc at ~~a
~ • ~ 5~c
(Street and Numbe~)
~5 7" , ~ , ~ ~ E, , St . Lucie County, Florida,
(n~Y)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domiciie in the State
of i'lorida. . ~ ~
(Inseri here any pertinr~t facts, surh as sale of pro{xrty or business, or relinquishment ot employment at fu~m'r
domicile~ removal uf family to new domicile, purchase of home. etc.)
, • H02~STEAD EXEMPTION:
ENTERI:~G, CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names:
~ ~ ¢
~Y rZY~ .
sL~.~ :l3~nrfu
a_ ~r ~.4i- =::~~~S~C
. -z : ~v _i ~
1 ~ z4 AM ~
2~~1~3
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I FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, and
comply ~vith all other requirements of a legal residcnt of this State.
I FURTHER CERTIFY tl~at I have no intention to return to my former domicile, and 1 intend to remain in
ST. LUCIE , County,
~e~ S l ~ ~ ~ , .
~ F.lo;ic~a~ ~per tly. (c~~r) .
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.::r;; ; • S IGI~ATURE
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~ Swbtn,~q.~~d~subscribed b.i~ore me this ~d:~Y of
74 ~
~ _ A.D. 19-----• . ~ e ~ ~
- "Q~ e s s ~
ROGCR POITRAS, CIERK IRCL?IT COURT Florida ~
~ ~
IIy ' _ 1c Deputy Clerk
~
(To hr rxec Wed iu Jupli.atr snJ oriRina{ f~l.d Nilh ('trrl Circuil C~,urt. and duplicaie ~ci+ 7ax As~eswr)
~ 22~ P~cE 3.2~~ ~
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