HomeMy WebLinkAbout0299 ~ ~
Declaration of D~micile and Citizensh~p
TO THE STATE AND COUNTY TAX ASSESSOR, ~rS~~~
ST. LUCIE Cp~y, FLORIDA:
This is my declaralion of Domicile and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in rnnformity with Section 222.17, Florida Statutes. '
1 was formeriy a legal resident of l and I
i~ltr~~ - ~ (stau)
resided at ~ Z . Howcver, 1 havi c ed my domicile to
tsereee a Numbe~)
and am and have been a bona fide resident of the State of Florida ' ay of
, 19____~., and 1 reside at Z ~ / -
(Sttest aad NnmDet)
~ ~ P/'C ~P _ St . Luc ie County, Florida,
(c~ir)
and this statement is to be taken as my declaration of citizenship, actual legal tesidence and domicile in the State
of Florida. . ~
(laseri kere anr pertinent facts, such as sale ot ptopertY ot ~us~ness• or relinquishment ot employmeat at tormer
domic~e~ removal ot fsmilr to new domicde. purchase ot home. etc.)
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION:
If entering children in school,
pl se list their names: .
~~c~~~::cu
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YEP.~~lEO~
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I FURTHER CERTIFY that i will register at my local address when the registration books reopen, and
comply with aU other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~ j~ • ~C ~ ST . LUCIE County,
[ i '
Florida,'permanently. ~G~r~
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' c' : °~~~3 c G~ : S IGNA'TURE
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~ to:~nd u~cti~a`~~efore me this day of
.S i n
A.D.19 74 ' - ~
.
~R" S CLERK CI UIT COURT ~~rT ~~Q,~C e, Florida
eputy Clerk
By iooK ~7 r~ 2~
(To be execut In dup~icate and ori6inal fJed with Ckrk Citcuit Coutt, snd dupiicste with Tu As~eswt)
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