HomeMy WebLinkAbout0431 ~ Declaration of Domicile and Citizenship
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TO THE STATE AND COUNTY 'CAX ASSCSSOR,
ST. LUCIE CpU~y~ FLORIDA:
'Iliis is my decl~ration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
: ....:•.....:~ti c,.~~~~., ~~2.17_ Flnrida Statutes.
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1 was formerl a legal resident of ~ ~ ~'M~ and I
y (Cilr) (St~te)
~~~,J ~5~,~~ . However, I have changed my domicile to
resided at
(Street ind Number) ~
and am and have been a bona fide resident of the State of Florida since s ~ day of
/o~•d , 19-~ and I reside at ~'~U J~~/~~cc~o~ •Li? _
(saK~.~a H~~eK)
~~o~C~ . St. Lucie County, Florida,
(ctiir)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
~f FlQrida.
(l~uert here snr Pert~neot faets, such ss sale of property or businas. or ~elinquishment ot emplorment at tormer
~u
domic0e, removal oi familr to new domicile. purchase ot home. etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION:
If entering children in s~hool,
please list their,names:
~1-Q~ ~c~ iJl~k~(~1~ ~ AJ K ~ ~ ~2 .
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~$~.40$
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~ f~~o ~n aECaaoE~
~ . st. LUCIE COUNTIf fl
ltOCER POITRAS
CLERK CIRCUI7 C01lIlT
RECORD YEa.iFtE~~---
.
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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.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend~to remain in
~~t ~ ~ ST . LUCIE , County,
Florida, permanendy. tacy~
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_ ~ _ - SIGNATURE
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'"Y~. ~ yf'~~~•• _ before me this ~ Y
~=$~iotn to,'ain~:su'.~'sQ~~; da of
~"•~u ~ A.D. 19 74 ~ 93d S~u~%uc_,~ Li?.
~ <<. ~ ' ng re
ROGER POITRA , CIERK CIRCUIT COURT , Flori3a
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gy ~n
~ lc.c.tf' Deputy Clerk 0 R~
aooK ~7 ~c~
(To be e:ecuted in duplicate snd oriRinai tdtd with Cle~k Circuit Coutt. ~nd duplicate with Tax Asseswr)
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