HomeMy WebLinkAbout1422 . • • • • -
. Dectaru~~on c~f Domicrte and Citizen~hip
TO THC STATI: ANV C'UUN'1'Y 7'AX ASSL~.SSUR,
ST. LUCIE CpUNTY, r~oKlnn: 2~~~Q~
Tliis is my dcdaration of Uomicilc and Citizcnship in the Statc of Fiorida ihat 1 am filing this dsy in
acconiancc, and in cQnformity witli Scctian 222.17, Florida Statt~tes.
:
I was totmerly a legal resident of _ ~ ' ~ ' ~ ~ , , " " and 1
. . . (ci~Y) / _ (sate)
. ~ - t r,:,, ; ,1 wi.(
nsided at ~ 1 . However, 1 have changed,,my domicile to
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(Street aod Numbe~) ' f ,
and am and have bcen a bona fide resident of the Statc of Florida since i 7 day of
• ~
19~ and I residc at - :~-J~- ~ r ~ ~ ~ ~ -
,7 ~ ' f- . ` • (Stteet and Number)
r ~ ' St Lucie
~ - , ~ ~ . County, Florida,
rij ~'~L~-ft , .
. (Citr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. •
(Insert het~ any pe~linent facts, such as sale ot property or business, or relinquishment ot employment at tormer
domicile~ removal ot family to new domicile, purchase ot home, etc.)
• • HOMESTEAD EXEMPTION : ~
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school,~
please list their names:
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ti
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J,~ r 1' ~ ''t~ ~i~ G j ~ ~i
F LE~ AM4 RE40a0ED
- f~.lUC1E COUN7Y FLA. -
Roc~F ?01TR~?s
CLERK Ct:.~,UiT COURT ~
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~ I FURTHER CERTIT'Y that 1 will register at my local address when the registration books reopen, and
~ comply with ail other rec~uirements of a legal resident of this State. .
~ 1 URTHER CERTIFY that [ have no intention to rcturn to my former domicile, and 1 intend to remain in
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p i' ,.s ~ ~ ~ ST. LUCIE , County,
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Florid~, permanently. ~ ~
. , , - ~
_ .
'c.;•• ' , -
. . ~ •
~ ` ` . - - . ~ S IGHATURE
~ . ~ ~
S~torn-to~~n ~z{d bcforc mc this ~ Z day of ~ ~
~ ~ ` . z~..: ' ~
~ 74 . 1 _ / ~ `~,r
- _ A. D. 19---• ~ ~ Z~g ` re s s
4;;~ •
RO~ER ' • ~ITRAS, CLERK CIRCUIT COURT `-T ~ ~ ~
, ~i~~.~.~ _ _ , Florida
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~:z g Deputy Clerk ~~~j ~YA~t 1~~.1
d~ Gr:
(Tu be eae tcJ in duplic~tr and o~iKin.d fil.d wiih ('1.•rk Circuit Cuurl. anJ duplicate with Tax Assesaut)
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