HomeMy WebLinkAbout1443 Dec~aration of Domicile and Citizenship
"I'O Tlil: S"CATI: ANU CUUN7'Y 'I~AX ASSk.SSUR, l 2~Ui1'7
`ST. LUCIE COUNTY, FLORIUA:
Ti~is is my dcclaration af Damicilc and Citizcnship in the Statc of Florida that I am filing this day in
accordance, and in conformity witlt Section 222.17, Florida Statutes. ,
1 was fom~crly a lc~;al resident of • ~ and 1
(ct~r) ' (sue~)
resided at . However, I have changed my domicile to
(Strcet and Tiumber)
and am and have becn a bona tide resident of the State of Flo ' since r- day of
, 19 and I reside at ~ -
. (Sueet an Number)
' ' St. Lucie County, Florida,
~ -
and tl~is statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
(Inurt here any pertinent facts, sucA as sale of property or business, ot relinquishment of employment at tormer
domicile, removal of faaiily to new domicile, purchase of home, ete.)
• ~ HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ .
If entering children in school,
please list their names:
r .
.
,y~tj~
1~:~
r
fllf~ ~~'~E1 ~A
StUiC1E ~00lf~ .
Rt,zER ?OtTt~?9 ~
CLEit~c tt+:i.il~i C0~ ; -
G Rsr,q~t~ ~fn.ftFB
~
~
~
x
} .
~
~ 2C7V~~~
~
~
~
~
E
~
~
~
~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requiremcnts of a legal resident of this State. _
~
~ ~I FURTHER CE I Y that I have no intention to return to my former domicile, and I intend to remain in ;
~ . ST. LUCIE :
~ , County, ~
-
~ Florida, permancnt y. (c'~y~ {
r~ ,
- 1/ ~
f~c~ b t' r T O v ~
C A.Qd i f
- IGNATURE
r,+~
" Sw~rn tQ.end ~s~scribed beforc me this ~ day of ±
~ , ~ A.D. 19 74_.' ress ~
x:: ~ : i ing =
a:K°~ . _ .
:~OGE ~ POI~R:~?S~t =:CLERK IRCUIT COURT , Florida
~$Y ~ ` Deputy C1erk •
~ ; , - .,~QS'.~c,,+z~;.,~,.
_ .~(31~ be euc ed in duplica~e anJ ori~;nrl (ilyd wilh L'trrk Cucuit Cuurt. ~nd duplicale wilh Tax Assessor)
~ R 226 ~E i442
~ BOnM q
~ - - -r~
_ , . : ~