HomeMy WebLinkAbout1759 eclaration of Qomicile and Citizenship y~ t
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1~) Tlll: STATG ANU GOUN7'Y TAX ASSL'.SSUR, 28Q332
ST. LUCIE _COUNTY, FLORIDA:
Tl~is is my declaration of Uomicile and Citizenship in the State of Florida that I am filing this day in .
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accordancc, and in conformiiy with Scction 222.17; Florida Statutcs. ,
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I was forn~erly a Iegal resident of , ~~~~y~ ,i~~
. However, I have changed my domicile to ~
r~ sidcd ai
(Street and Number)
day of
;utd am and have becn a bona fide resident of the State of Florida since
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_ , 19.~-, and I reside at ~st t sad Number)
~-i ~ ~ lAri 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 here sny pertinent tacts, such u sale ot property or business. or relinquishment of employment at fotmet
domic~le. temoval of (amily to new domicile, purchase ot home. ete.) ~
ErITERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION:
If entering childxen in school,
please list their names:
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ftLEO l111D ~fCOi~E~ . ;
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~G;r.CUtt COYRT
~ RECORO YERif ~EO
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~ 280332
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~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
~ comply with all other requirements of a legai resident of this State.
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~ I FURTHER CERTIFY that I liave no intention to return to my former domicile, and 1 intend to remain in
ST . LUCIE , County,
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Florida, permanently. ~~'~Y~ -
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. . SIGNATUR~
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da of
,=T~ S~vorn_tq-and sub"s.Er~c~.beforc me this Y
~ - ~ A.D. 19 74 . ~o ~ Z ~ ;
- - i ing re s s
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Rpr~~~~~ .~T~I~AS~ aCLERK IRCUIT COURT 1_0~,,~,~~_, Florida
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r= BY ~ Deputy Clerk ~ ;
~x R ~~RK 22fi PA~~ 175 ; t
(To be ta uled io duplicatr +nd origin:J flled w~ilh Clerk Circuit Court, and duplKate wilh Tax Assessor)
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