HomeMy WebLinkAbout2947 Decia~ratio~n af ~omicile .and Citizen~~ip
"1'O Ttlt: STATI: ANU COUNTY TAX ASSESSUR, _ ~~~3
ST. LUCIE Cpt1NTY, f LORIDA:
This is my dcclaration of Domiciie and Citizensl~ip in the State of Florida tl~at l am i'iling this day in
accurdancc, and in conforn~iiy with Section 222.17, Florida Statutcs. ,
1 was formcrly a Icgal resident ot b~~ ~kl , and 1 -
~citr) (state)
resided at _~~~-~:-g ~ ~ . However, 1 have changed my domicile to
(Street and Number)
a~zd am ~ and have been a bona fide resident of the State of Florida since ~ day of
, 19_~____, and I reside at d
(S t snd Number)
~ ~rG ~ St . Lucie County, Florida,
.
. (c~~r)
and tl~is statement is to be taken as my declaration of citizensl?ip, actual legal residence and domicile in the State
of Florida. . ,
(Insert here any {+ertinent facis, such ss sate of property or busineu, o~ relinquisl~ment of emploYmrnt at former
domicile, removal of family to ocw• domicile, purchase ot home. etc.) - ~
ENTERING,CHILDREN IN SCHOOL: ~ NOMESTEALI EXEMPTION:
If entering children in school,
please list their nacr.es : .
; . ;~,,t, ~9~ 9 a~' ~ -
~°G~ ` t , , .
C~'~
~9 ?D•~
~ 1 6,
~ s,~.~ ~,-e~ ~
~
~
~ ~ ~ /~~~;t~ _ \
~ • ~ J~~ ~ FILEC ANO RECOIt
ST. LUCtE COUNTY FOEL,A~. ~
- R06ER POITRAS
CIERK C~RCUtT COURT
RECOti~ YERiilEQ
t
~ ~ ~e s ~7~
E
P •
e
~ - 2~9
~ ~`~'3
I FURT}lER CERTIFS' that I will register at my local address when the registration books reopen, and
comply with all otl~er rec~uirements of a legal resident of this State.
1 FURTHER CERTIFY that I liave no intention to return to my former domicile, and I intend to remain in
' ST. LUCIE County, ~
/ ~ ~ - - '
_ Florida, perm~~Y• «~~Y~ Harold E. Pierce
~t_ . ~ .
, , : ~ il~P
; s t,.::L`~''• ' /r
~ i :
~r~~ ~y' ' ~ ~ -
~ ,a''~. - ~~(e~!Yll~dl~-.~- ~ ~Jr~!'y ~ _
~ -1` . ; : ~ s icxATUxE
r;^~~,~, _ ; Sarah F. Pierce ~
~.a~~~'~.r-; , {
~vsrprnEto and~~~scribcd bcforc mc this __~U day of t
i
A.D. !9_74_. .
i ing ress
KOG1:R OITRAS, CL.ERI: I:?C(:IT CC~URT , Florida ~
~ , ~
By~ ~ `~C ~c,~ Deputy Clcrk _
2~5 ~~2J4i
'j~~ I. ~trJ in duplrc.lr and ~~ri~in.d fil~~d wilh (li?t. fi:cuil Cnutl. and duplicate Nilh Tax Asussor)
.d;`` D -kh'3 ~ .r"'G ~ ~ sti.. S .~s:'~'%,'Y "V~
i,,~r~~`,.g. e^i-~~~"
~ ~ ~ ~ ~ _
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