HomeMy WebLinkAbout2143 Declar~tion of t~omicile and Citiz~nsh~p i
"i'O Tlfl: S"fATt: ANU COUNTY "fAX ASSI:SSUR, 2~
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ST. LUCIE _ COUNTY, ~LORIUA:
Tl~is is my dcclaration of Don~i~ilc and Citizrnship in thc Statc of I~lorida ihat 1 am filing this day in
a~corda~icc, and in conforniity with Section 222.17, Florida Statutrs.
1 was formcrly a lcgut residcnt oC ~I~v~"~ - , and I
(c~~r) (sa<<) ~
resided at '~-S~O p~ -~~s . However, 1 i~ave changed my domicile to '
(Street and Numbe~) }
and am and have becn a bona fidc resideni of the State of Florida since ~_~ay of
/~~1 RC ~ , 19~~, and 1 rcsidc at -~/S -EA S~ G
(Slreet and umbet) ,
f'~ E- , St . Lucie County, Florida,
tc~ir)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. • . ,
(Inurt here any perlinent facts, such u sale of p~operty or business, or relinquishment ot employment at former
domicilz, temo~•al ot family lo new domiciie, purchase uf home, elc_)
. ~ HOMEST~AD EX~MPTION:
ENTERING.CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names:
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1
. Fi~EO:?~rt ?:EG;?ROEO
ST. LUC~f. C~UMTY FLA. ;
'~AS
CIE~.~.~^~ ~~~/17 COIiRT ~
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I FURTHER CERTIFY that 1 will registcr. at my local address whei~ the registratio~i books reopen, and
comply H~ith all otlier requiremcnts ot a legal resident of this State. _
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
. ST. LUCIE County,
~j~; -y ,
~~lorida, pcrmanently. ~~'~y~
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~;r o: _ S IGI~iATURE
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~'to and s~bscr~bed Uefore mc this day of ~
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~ ~ y~ = ' ~ 74 #
y~: i .ll. 19 . i ing re s s ~
~Q . .,~45, CLERK CI~?~UIT COURT
, I'lorida
~
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By 1 ~zty Cler~
(To t ~:u d in duplic.,. :J nri~~in.il (lyd Hilh ('IerA ('~rcuit Conrl, and duplicate ~~ilh Tax Aceeswr)
`8'~~K 225 p~E2140 -
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