HomeMy WebLinkAbout0280 De~
;tar~~~on of Dor~nic's:~ a~d ~i~e~~~~~
~ 2'7330~
"1~C) TNt: STA'l~t: AI~D t'UUN7Y 7'AX ASSL~.SSUIt,
ST. LUCIF ~-0Uh7'Y, FLORIDA:
71~is is my d.•rlaration of Uomicilc and Citizcnship in ihc Statc of l~lorida that 1 am filing Uiis day in ~
accor~ancc, and in conformity with S~c;tion 222.17, Florida Statutcs.
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1 was formerly a Icgai residcnt of _ ' ~s,,,~~
(c~tr)
/ . tiowever, 1 l~ave changcd my domicile to
re~id~d at _-~--~~-1- ,
~,,..r,~. (Strcet and Numbcr)
~ ~ day of
~ind am and have bcen a bona lide residcnt of the State of Florida si~ice
19 and 1 residc at I~- D~- A vz • ~
' (Street and Number)
_ ~ ~ ~ _ . St . Lucie _ County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~ .
(Inseri hete anY Prrlinrnt factc, such as sale c~f properly ur businrss, or rrlinquishment of emploYment at tormcr
domicile, remos~al of f:.tnily to uew domicile, purchase of home, etcJ ~
EPiTERING, CHILDREN IPd SCHOOL: HOMESTEAD EXEMPTI(1N:
If ente-ring children in school, ~
please list their names:
2'7~3Q~
~j u{ G, ~ ~ r,~ ~ fILEO ~n~ aEC QRpEO
ST. LUCtE COUN11? l~lA.
ROCER ?017RAS
~ f~, a r CLERK C:HCU!T COURT
RECOP.O VEk's1ED~~
~ ~ ~ ~ ~ ~ ~ - pnt 1 I 3 39 PH'1~1 ~
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~ I rURTHER CT:RTIFY that 1 will m~ister at my local address when the regist?at:on books reopen, and
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comply witi~ all othcr rcquircmcnts of a legal residcnt of tliis Statc.
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I FURTHI:R CERTIFY that I have no intcntion to return to my fonner domicile, and I intend to remain in
• ST . LUCIE County
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H1oci~~rmas~ ntly. (c~~y~ "
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:=;a SIGi~kTUR~
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S~~~orn tb'ai~d subsrribed Ucforc mc thi` ~aY or
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= A.D. 19_74__. -~"i i?~b ATc ress ~
RCGER POI.TRAS, CLERh CIRCP~IT COUI?T T~~ 1~ 1 Florida
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- ~y~~~~ Depu~y Cl_er.k
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( In br c~crutrd i~i du~~li:~~r .~nJ ~~r~;in~l (~Icd ~~ith Clc~k l'itcuil ('~~url. and du{~li.ele ~~~It~ lax A•acssor)
~s • ~ s~`K~~6 F~~ ~80
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