HomeMy WebLinkAbout2302 2bU'71~ u ~
~ Declaration of Domicile and Citizensh`p
TO THE STATE ANU COUNTY TAX ASSESSOR,
ST. LUCIE CpUNTY, FLORIDA: '
This is my declaration of Domicilc and Citizcnship in the Statc of Florida that 1 am filing this day in
accord'ance, and in conformity with Section 222.17, Florida Statutes. ~
: l% ~2/~ ~ ~c. - and I
I was formerly a legal resident of n~~r~ ' ~ e~~
resided at ~ g~h~ However, I have changed my domicile to
(St~eet and Number)
and am and have been a bona fide resident of the State of Florida since , day of
- ~ , 19?~, and I reside at ~ ~ . ~
^ (Street and Number)
f~~~~~ . St . Lucie County, Florida,
J " (c~tr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Ftorida. .
(Inserl here sny pertinent tacts, such u sale of propertY « b~iness, or telinquishment of employment at tormer
domicile. removal of family to new domicile, purchise of home, elc.) ~
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION:
If entering children in school,
please list their,names:
~,~tIC1E
CDlfil~~ ~
~p~,f ii ?JITIUS ~
- e~c~e v~s
=iEO ~T
~
' ~e~t 29 8 IM'~~t
~
~ - 28~0`7~:3
~
~ ESTABLISHIrIG RESIDENCE IN ST. LUCIE
~ COU:~ITY, FLORIDA
~
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M
~
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I FURTHER CERTIFY that I will register at my jocal address when the registration books reopen, and
~ comply with all other requirements of a legal resident of this State.
~ I FURTHER RTIFY that I have no intention to return to my former domicile, and I intend to remain in
K'
ST . LUCIE
~ 4 , County, _ ~
Florid~~e
,l'manent~ • ca~r)
= r,`~it:t~• '~,L` . L~~~~'~
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- ~~s~ , - ~ ~ ~ ~RS1~ ~ ~a,~TE~Z
; ' _ r ; : - S IGNATURE
!
~ ' ~ ,~c day of
gvyis~n•'t~~aL~..~~crtbe'd,before me this
° A.D.19 74
i ing re s s
ROGER PO TRAS, CLERK CIRCUIT COURT , rlorida
~w
gy Deputy Clerk p~ 2301
- e~oK 226Y o~~E
R;i;__, (To be e cuted in duplicate snd origina) filed wilh Cletk CircuR Court, and Juplicate wilh Tax Assessor)
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