HomeMy WebLinkAbout2897 Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 2~,~ ~O
ST. LUCIE COUNTY, F1.ORlDA:
'[liis is my dcclaration of Domicile and Citizensl~ip in the State of Florida that 1 am filing this day in ~
accordance, and in conformity with Section 222.17, Florida Statutes.
I was formerly a legal resident of j~~~ L~ , n and I
(c~iy) (
resided at ~ ±~~~Q~ ~/"/-~-1~- ~-~~2~• . 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 1 reside at 1,~~ ~~-P1't
' (Street ~nd Number)
~1 ~ . St . Lucie County, Florida,
(cicy)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert hcre any pertinent fxts, such u sale of propertr or business, or relinquishment of employment ~t tormer
domicile, temoval of family to ~~evr domicile, purchase of home, etc.)
• NOMESTEAD EXEriPTION :
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school,
please list their_names:
~,('e~-~ /'n_~~
~11EO a~ 9ftatp~
~ ltK7F ~OdMiY F~,
~ S~C~R ~{~!TitAS
~ Ciflt? CI=:CWt CpURT
; RECnRD Yr??Fl~d
I _
~ 1 ~ I ii AM'T~!
:
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~
~ ~~.41~0
~
~
~
~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
~ comply with all other requirements of a legal resident of this State.
~
K I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend~to remain in
~ '
p • ST. LUCIE
~ , ..D~-f~ ~ ~~.~[i.~11. , , CountY,
~ Florida, permanently. «'~y~
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" t, . ~ond~'iclr~
_ ~ : ~ ' ~iri~:,~~,;,-•:~v~.•-. ~GI~ATURE
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_ _ .~~11. ~ : 7~~~t~~-
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-,~,Syvom:to bcd before me this day of
~
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= 74 . ~
•s=:. _ A. D. 19- 1
~ . ~ ~ i ing res s
'
~"-~t~`•~f~~fj0• _~RAS, CLERK C RCUIT COURT , Florida
gy ~ ~c eputy Clerk ~ ~ ~~n~
~j ~"C!( %t E y
~ (To be execu ed in duplicate aod original f~led with Clerk Circuit Coutl, and duplwale with Tas Asxuot)
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