HomeMy WebLinkAbout1318 Declaratian of Domicite and Citizens~~p
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1'O Tlil; S7'ATt: ANU C'OUN7'Y 1'AX ASSL:SSOR, 2'~'~r~~.~
ST. LUCIE CpUNTY, FLORIUA: ,
This is my decfaration of Uomicilc and Citizrnship in ihc State of Florida ihat 1 am filing this day in •
accordancc, and in conformity with Sectiun 222.17, Florida Statutcs.
1 was formerly a legal resident of •S ~ ~ + ~ t-- ~ ,--I~-l ~ K - and I •
(CiIY) (Stste)
resided at ~y ~ M~ E . However, I have changed my domicite to
(Street and Number)
and am and have tx:en a bona fide resident of thc Statc ot Florida since day of
I'19 t~ 19~ and I residc at ~1 +J ~-~--~F ~
- ' (Street and Number)
p~R~ . 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. .
(Inseri here sny pertinrnt facts, such u sale of property w business, ot telinquishment ot employment at former
domiciie. removal ot fsmily lo ne~t domicile. purchase of home. etc.)
• ~ HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~
I£ entering children in school,
please list their names: Q~c.,.,~~.sNME.,r e~ k~p~-yME..?t ~t
- FacnrCic Aon ~a iLf.
~ortc,K~s ~E oF ~aa.6
FlLEQ L*~;: s*rtiJ~ A
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Rt1L [ ~ ~ ' i 3~1s ~
CtE~I~ ;i-:l:t COURT
Pr~l:' t: - ~l
~ j~ 22 ~
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~ I FURTHER CERTIFY that I will register at rny locai address when the registration books reopen, and
comply with all other requirements of a iegal resident of this State.
1 FURTHER CERTIFY that I i~ave no intention to return to my former domicile, and 1 intend to remain in
~ ~ E~ct ST. LUCIE County,
Florida, permanently. cc~~r~ ~
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; S IGI~ATURE
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~ S~vKp~jt t anit ~u~cdticd beturc mc this ~day ot '
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A.D. l9_~ ~U ~ ~ S f~
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i`Ting ~t re s s
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RQGER POITRAS, CI.~RK CIRCUIT COURT P~~c,~~~, Florida
~ -
~ ~ De ut Cterk '
~ By ~ uu P Y ~
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(Tu be caecuteJ iu Jup6c~~e ~uJ rni~inal fil.d ~silh ('Irrk ~ ircuit Cnurl. and duplicatt wilh Tat Assessor) .
B~~K225 P~cE1316
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