HomeMy WebLinkAbout0495 ~ ~
Deciaration of Domicile and Citizenship ~
~
TO THE STATE AND COUNTY TAX ASSESSOR, 2~~~
ST. LUCIE CpUNTY, FI.ORIDA:
'Iliis is my dcclaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
1~1~1 7 C1...:dn t~ ~ tP
accordance, an~ in conf~eniiiy wiih ~ ~ + + "s+""' ~
1 was formerly a legal resident of ' , and I
(City) (St~te)
tesided at ~ . However, 1 have changed my 'domicile to
( t ~nd Numbet)
and am and have been a bona fide resident of the State of Ftorida since day of
19...~~...., and I reside at ~S~ G"'~
= -
~ (Strat aad NumEer)
~ • St . Lucie County, Florida,
~
(ctir)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ,
(Insert here any perlioent facts. such as sale of propertY or busi~as, or ~elinquishment of emploYruent at tormer
doaiicle. rea?oval of tamily to new domicile. purchase of home. etc.) ~
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION:
If enterin children in school, ~
p~ease list their,names:
/ •
FILED ANfl RECOADE
iT~ ROCERCF013R~S
CLERK CIRCUlT COURT
. RECORO VER:FIED
; - M~r l 10 ss AN'~~i
~
~
~~314fi1
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
~ ~ . ST. LUCIE County,
w,~/.t .t '
Florida, permanently.
. } - , f
3:.~~~~~...::,~` /
~j~~'~j' ~.5i_..
: ~
C ~ •F?~7i.a.~
, g~~:~.,.,..o~~,,~...._ ~o ~ ~Lh a, e lle
~
~ -
_ ~ ~ :'~:~-~Y ° ~ iwi ~f ~ - S IGNATU
.
: ~ . = ~
~ : ~Y .
, • , day of
t~~ ~'bed before me this .
~ A. D. 19 74 g r s s
. ~e
ROGER ~p~ RAS, CLERK IRCUIT COURT , Florida
gy ' Deputy Clerk d~R~~'1 p~ 4~
(To be ezec t d in duplicsle snd ori6inal filed with Clerk Circuit Court, and duplicate witA Tet As~essor)
:
~ , - -
~~z ~