HomeMy WebLinkAbout2645 Declaration of Domicile and Citizenship
. 28U914 s
TO TNC STATE ANU COUnTY TAX ASSt~SSOR,
ST. LUCIE _ COUNTY, FLORIDA:
This is my declaration of I~omicile and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in conforn~ity with Section 2?''.17, Florida Statutes.
andl
! was formerly a leFal resident of o_ ' su«)
(citr)
resided at ~ . However, I have changed my domicile to
(Street snd Number)
and am and have been a bona fide nsident of the State of Florida since ~~~j!Sday of
S~ ~'T • /S , 19 and 1 reside at ~ • L'r~°~ ~t `Zt-~~`
(Street and Num r)
, St. Lucie County, Florida,
(c~sr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert Aere any pcrlinent tacts, such u sale of pruperty or Dusiness, or relinquishment of employment at former
domicile, removal of tamily to new domicile, purchase of home, etc.) ~
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: _
If entering children in school,
please list their .names:
~ ~ T ~ ~.S LL i i ~ ~~~91`~
fit.~Q «~c~~FO =
- ST.LUCiC C~tlMTr fLA.
ROCE~e ziiITRAS
Cl£R~I C~::GU~T COURT
Rf.CORD YsF~ftED
~
9 3c AN'?~I
~ Mwy ~ ~~t 4~f~
i ~
~ _
~
~
~
~ '
~ ' i
,
a
~
~ -
6
~
S
~
$
~
~ -
~ J
~
~
~ I FURTHER CERTIFY that i will register at my local address when the registration books rcopen, and
~ comply with all other requirements of a Iegal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in
~
z,~
` ~i r C ST. LUCIE , County,
tc~~r)
Florida,_permanently. _
~-s
~ 'TURF.
:~-a
_ . r,• -
. - _
~ " ~ . ~ S IGNATURE
, . _ I
, ~ '
' Sworn to and subscribed before me this ~ day of
=j • ' ~~/ll~~ A.D. 19 74 ~
ti~~ i ing r s
ROGER POITRAS, LERK CIRCUIT COURT Florida
~
x ~
Y ~ ~R
F " g ~[.c_~Deputy Clerk
B~o~226 :~~.~~~~3
(To be e:ecuted i~ duplicate and oriRin~l filtd with Clerk Circuit Courl, and Juplicale with Taa Assessor)
s3.=€
~ 4 _ _ _ ;
_ ~
_
~ 4 _ . _ . . ..r _:~:rz~.