HomeMy WebLinkAbout1594 1f,
~ Deciarat~an of Do~icite and Citizenship
TO TtiG STATE ANU C'UUI~'I'Y TAX ASSk:SSUR, 280210
ST. LUCIE _ CpUN'1'Y, ~LORlDA:
'Iliis is my declaration of Domicilc and Citizcnsl~ip in thc Statc oi' Florida that 1 am fili~ig this day in
,
accorclancc, and in conformity with Scction 222.17, Florida Statutcs. '
' 1 was fonnerly a legal resident of t~m-L ~ , and I
(citr) (s~ate)
resided at ~ rn~~~~-e~ • However, 1 have changed my domicile to
(Street snd Number)
and am and have bcen a bona fide nsident of the Statc of Florida since day of ?
19.1
~ and 1 reside at ~ ~ I ~ ~ ~nr ~ 9~ J -
. ' . (Street and Numbet)
v .
~ ~Q~ ~ n~, ~ , ' S t. Luc ie County, Florida,
(ci~r) .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
(insett here any pertinent facts, such as sale of property or business, or relinquishment of employment st totmet
domic~le. removal of family to new domicile, purchase ot home, etc.)
• ~ HOMESTEAD EXEMPTION:
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names:
,
J p ~ D . ~
uCJ
FILEO AN~ REC4RDE~
8T. tuCtE COUNTr ftA.
! ROCER POiTRAs
! - CLERK C~RCUIT COURT
RECORO YE~~FIEJ
Anr 13 10 03 AM'?~i
~
28a21o
I FURTHER CERTIFY that I will registcr at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State. ,
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
° ST. LUCIE
~ }L ~ p p ~ ~ , County,
Florida, permancntly._ cc~~r) ~
` ~ .
r+~
~ ~ ~~~~u~.•~~ ' '
°'''~S' :'~~~~•'~J~~.r~ ' •f• ~ ' -
: SIGNATURE
~ ..~orrt to and sutis~r~ed before me this 3 day of ~
~ . , . t , : G~~x~.-w C'~~ -Q~
t - . . 74 . ~i~ ~t.
~ ~ - y: _ A. D. 19----
~ ' -+Ff'ai ing d' re s
~ ~ ~QtiI ~ S~ CLERK C RCUIT COURT ~L~ ~D~wD, ~ F1Urld8
Y~ .,rrr~r~,,u•~
~ gy~ ~ eputy Clerk gOC~226 P~i5~3
.
`=ri` (To be rxecv rJ in Juplirale anJ ori~iarl fifcd v~ith ('Irrk Cucuil Court, and Juplirale with Tu Assesso?)
- ~
~ - - _
~ _
, . . . x<