HomeMy WebLinkAbout1320 Declarat~on of t3omicile ar~~ Ci~izen~hip ~
"t0 TIIC STA1't: ANU COUN7'Y TAX ASSI:SSUR, ~ 2~3~~
ST. _LUCIE _^_~UNTY, ~LORIDA:
Tl~is is my dcclaratiun of Uomicilc and Citizcnship in the Stalc of FloriJa th:~t ! am filing this day in
accorJancc, and in conformity ~vith Section 222.17, Florida Statutcs.
t was forn~erly a lc~al residcnt of T~~/~ ~F~'~,~ and I -
1 (citr) (st.te)
resided at J'F'"F~~ ~Y~-~ • However, 1 have changed my domicile to
..r.~.... (Street a~d Number)
and am and have bcen a bona fide nsidcnt of the State of Florida since day of
, 19-~ , and 1 reside at ~ry ~ ~ ~ ?O 4 ~ .
(Street and Number)
~0 y~ ~ C~~ St . Lucie County, Florida,
~c~~y~ '
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicil in the State
of Florida. ~ ~ ~ 3 3
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(insert hcre any pertinrnt facts, such u sale of property or business, or relinquishinent o[ employment st tormer
dumicile. remo~al of family to new domicile, purchase of home. elc.)
* • ~ HOMESTEAD EXEMPTION:
ENTERING, CHILDRE.~ IN SCHOOL. ~
If entering children in school,
please list their names:
FIIED t?ND ~ECQe~DED ~
ST. LUCti C4lfMTY FLA.
- RO~f F. ~ ~~TRA~~
~~~;k C; ~~UcT COURT
RFCG=:f V~~ !:`r~
Mla< <8 12 3~ PH'1~1
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I FURTHER CCRTIFY that I will register. at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this Stafe.
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
l'`/ ~ O L' a~~ /~k ~0 ~ f Sf ' ~C„ t~C /C ST . LUC IE , County,
Florida, permanently.
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~ Swo~~o~ani~~ubs~~'ttic~li}~'o're mc this day of
. . .:4~ ~ v . 74 ~ ~ ~,~r~~a
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~i'~:` A.D.19_ -
- ~ ""7~[a i ing re s s
~ ROGCR ~0?I~~~aS, CLEP.K IRCUIT C01)RT ~~~~~P~-, rlorida
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~ ny , t^ Deput;~ Clerl: .
! iu t~c r~ cutrd in duplic~tc and utipi~.d (il.•J v~ith Clr+k Circuit ('uurl. and duplirale with Tax Asscsw~ : ~
~ so~x22~ PacE131$
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