HomeMy WebLinkAbout2465 ~
280'794 ~ ~ ~ "
Declaration of Domicile and Citizenship -
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TO THE STATE AND COUNTY TAX ASSESSOR, ;
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ST. LUCIE CpUNTY, FLORIDA: ~
'Iliis is my drelaration of Domicilc and Citizcnship in the Statc of Florida that I am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutcs. ~
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1 was formerly a legat resident of 1~ G'? s~~o .•~n ~ rs ~~i~~ ~ ~ and 1 ~
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resided at 3~~ v~n~ A y~ . However, 1 have changed my domicile to ~
(Stttet and NumDet) ;
and am and have been a bona tide resident of the State of Florida since ~ 9 day of ~
~/o v~.,, 6 E ~ , 19?
3 and I reside at ~ 1- 3 s~~ uG ~ e /3/~ e~ o~'e`/s`,~ i
(Street snd Number) `
~ St . Lucie County, Florida, '
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and this statemcnt is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ' '
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(I~sert hete any pertinent facls, such ss sak of prope~tr o? business, or relinquithment ot employment at [ormer :
domicile, removal ot tamily to new domicile, purchue of home, etc.) ;
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ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: _
If entering children in school, ~
please list their ,names : ~
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~ 280'79~
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~ I FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, and ~
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~ comply with all other re~uirements of a legal resident of this State. £
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~ 1 FURTHER CERTIFY that [ have no intention to return to my former domicile, and I intend to remain in ~
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ST. LUCIE '
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4' Florida, permanently.
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- _ ~ _ ~ ~ S IGNATURE
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_ Sv~oan to and;~ubscabed before me this day of
~ Y,~ Q- 74 ~0 1- 3 S~~ vc~C ~o f~S~
sp..~a:. _ A.D. 19 1 ng ress ~
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~F_, '~-~~EI~~OI'~RAS, CLERK CIRCUIT COURT o~ f Florida -
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By . Yn C puty Clerk 60~JAiG~~ P1~6E2~~ •
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(To be e:ecuted io duplicate and original filed with Clerk C'vcuit Co~~rt, and duplicate wilh Tax Asxeswr)
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