HomeMy WebLinkAbout1413 D~ClaY'~tlari OT t~vm~c~~e c~i lU ze~c:4
TU Tlil: S7~ATG AnU COUNTY '1~AX ASSI:SSUIt, %
BQ~;:;~
.ST. LUCIE COUNTY, I=LO1t1UA:
This is my drelaratiun of Domiciic and Citizcn~hip in the Statc of 1=lorida that 1 am filing this day in
accordancc, and in conforn~ity ~vith Scction ?22.17, Florida Statutcs.
1 was formcrly a lcgal nsid~r.t oi c r~~r~'U y~'/GNTS ~ ~tio iS _ and 1 '
~c~~Y~ (su<<)
resided at C'~~ ST ~Vc~ _J'~ . Howcver, 1 have changed my domicile to
(Strret aod Number)
and am and havc bccn a bona fidc residcnt of tl~e State of Florida since 3o T'`~ day of
D~To r3 tA~ , 19~ and 1 residc at 3 O G Z E~~f`1~
(Stteet and Number)
~ _ . St . Lucie County, Florida,
- - (ci~Y)
and this slatement is to be taken as my declaration of citize~iship, actual legal n;sidence and domicile in the State
of Florida. . ,
(Insert here any pertinrnt fxts, such u salr ot pruperlY a business, or relinyuishme~l of employment al tormer
domicile, removal uf family lo new domicile, purchase of home, etc.)
. ~ HOMESTEAD EXEMPTIONz
EA~TERI?1G, CHILDREN 1N SCHOOL. ~
If entering cllildren in school,
please lise ~heir nar:nes:
fILfL' dv: %~fCGROEo
fT.IUL;? tt~1TY fLA.
, R~~`r ;:?T C URT ~ ~
CLEFR C: ~
~r~~: , ~f ~ rcG
I~t 1y ~ s6 AN'Z~I
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; 2'73~~~
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~ I FURTHER CERTIFY t}iat 1~vill rcgistcr at my local adciress ~vhen tl~e rcgistration books reopen, and
comply with all olher requirements o~ a legal resident ot this State.
I FURTHER CERTIFY that I l~avc no intcntion to rcturn to my fonner domicilc, and I intcnd to rcmain in
ST. LUCIE County,
Fr /~iF.rzC - ~ '
Florida, pcrn~ancnUy.
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~ G,: Jz` ` . n, r r . . _ - S IGi1ATURE
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~ '~~refn'~~i~ ~ ~-bcforc mc this _ ~ daY_ or
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~0 ' :"r"r~ 74
A.D. 19---- • ~ , zi .ing ress
F
ROGER P(}I~I~AS, CL.C~:K . T~:CUTT COURT , Florida
g Deputy C~.erk '
y -
(Tu Ix rxrcu d in duplic~~c :.uJ uri~:in.~l f.lyd ~cith ('Irrk ('ircuit ('onrt, and duplicate ~vith Ta~ Asscssur)
BGGK
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