HomeMy WebLinkAbout1559 Dectaratian of Dom~c~ie ana ~~j~zensn~p
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"TU'ftlG S1'ATG ANU CUUN7'Y 7'AX ASSI:SSUR,
~ST. LUCI~ _ CpUNTY, FLORIUA: .
'Iliis is my dcclaration of Uomicilc and Citi~cnship in thc Statc of rlorida that 1 am filinb this day in ~
acconlaiicc, and in conformity wilh Sectioi~ 222.17, Florida Statutcs.
I was fornicrly a lcgal residcnt of ~Q~~~?'x°~ ~n ~e-~a . ~ and I -
._r._ _ (c~~r) (s~.~~>
r~sided at ~~'~C~L-..s-' ~ . However, I have changed my domicile to
(Street snd NumAer)
and am and have Ix.~n a bona fidc residcnt of the State of Clorida since _L-~ day of
~n~ _ , 19-~ and l residc at .
- (9 rat and Number)
/~~,r~,P St . Lucie County, Florida,
.
~c~cr)
and this statement is to be taken as my declaration of citizensl~ip, actual legal residence and domicile in the State
of Florida. . , . • •
(Inuri here any pertinent facts, such u sale uf pn~perty ur busincss, ot relinquishment ot employment at formet
domicile, remo~~al of family to new domicile, purchase of home, etc.)
. ~ HOMESTEAD EX~MPTION:
ENTERING, CHILDREPI IN SCHOOL. ~
If entering children in school, 2~81~3
please list their names:
FILED 4k~ ~ECOROEO
- ST.IUCIE C~UHTY fLA.
ROGE= ?C~~'+RA~S
CIERK C: tiLU:? ~OURT
RECO~[~ '?'E ~:F:EJ ~
~ ArR ! 9 3~ AM'7~1~.
, _
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f ~
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I FURTHER CERTI[=Y that 1 will registcr at my local address when the registration books reopen, and
comply with all other requiremcnts of a lcgal resident of this State.
1 FURTHER CERTIFY that I liave no intention to return to my forn~er domicile, and I intend to remain in
~ - ST. LUCIE County,
~,~rc e
Florida, permanently.
~ ` `~!i; . . _ .
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SIGNATURE
~ - . . ~ `_t
, , t : tt, ~ _
~ Swoiri to. and subscqbEd. before me this day of
~ _ - A.D. 19 74 . . ress
~ , z iiig
ROG~R POITRAS, CLERK CIRCL'IT COURT , Florida
g/~,o.~_~ co P- ~2~ Deputy Clerk ~
Y
(To be rxcculcJ in duphirtr and uri}in.t htrd ~~•i1h ('Irrk Circuil Coutl. aod duplicatc N'ilb Tax Asusso~)
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