HomeMy WebLinkAbout0010 Dectaraticn of Dor~icile and Citizensf~~p
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~rc~ "flit: S1'ATI: ANU ('OUN7'Y "TA~ ASSI:SSUIt.
ST.~ LUCIL,------ couN~rY, [~l.oft~DA:
~I~is is my drrlaration of Damicilc. and Citizrns!~ip in th~ Statr of i~loricta that ! am tiling this day in
accor~lancc, and in canfonnity with Scction 222.17, rlorida Statutes.
~1 and 1 -
1 was tom~crly a lcgal residcnt of _ +r -P- ~S„~~~
(ci~r)
rrsided at `r-~ -~-~~~h L?~~-- • However, I have changed my domicile to
r (Street and NumAer) _
and am and have becn a bona Cdc resident of the State of Florida since day of
- 19_,:~.s~-, and I residc al -__L_~~~~.'~1 ~y~
h ~.~fe~~'
~ (Street and Number)
i~°Y!'P _ _ _ . St . Lucie County, Florida,
. (City) ,
and this statemcnt is to be taken as my drelaraiion of citiZenship, actual lrgal residence and domicile in the ~tate
of Florida. .
(Inseri he~r any pertinrnt farts, such as sale ut prupcrty or businrss, or ~elinquishment of emQlayment at former
domicile, remo~'al of family to uew domicile, purchase of home, etcJ
ErI'rERING CHII.DREN IN SCHOOL: ~ HOMESTEAD EXETtPTION: _
If entering children in school,
please list their names;
. ~ Q n~ c~ p p~~~^~ -~o r a~
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I fILED AMQ RECQRQE~
! ST. LUCIE COUNTY FIA.
' ~ ROCER ?41TRAS ~
4 CLERK C:3CUIT COURT
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~ _ RECORQVfR~FtEO.~..~.-•+ ~ ~L
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F A~s t0 12 vo PN
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~ 1 FURTIIER CERTIFY that I will register at my local address when the rcgistration boohs reopen, and
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~ comply with al! other requircments of a lega( resident of this Statc.
~ 1 FURTHER CERTIT'Y that 1 have no intention to return to m~~ formcr domicile, and I intend to rcmain in
~
~
~ ~ ~ ST . LUCIE , County,
'
~ Florida, p~rmanently. cas,~~
:ry
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Stv,'orn to xti`cl.ti~cTibed Ucforc mc thiti ~1~~)• o~
ea~ ~,r~...P~ A.U. 19 _74 ress
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I'.OGCR I7'R~~S, CLER~: CIRCLIT CnURT , I'lorida
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