HomeMy WebLinkAbout0866 Deciaration of Domiciie and Citizenship
TO TtiF STATE AND COUNTY TAX ASS~SSOR, ~1,~~6 ~
ST. LUCIE COUNTY, FLORIDA:
'Il?is is my dcclaration of Domicile and Citizcnsi~ip in thc Statc of Fiorida that 1 am filing this day in
accorJance, and in conformity with Scction 222.17, Florida Statutcs.
I was formerly a Icgal resident of ''S R~ d' / ~C ~v yd'P~ , ~v and i
(ci ) (s te)
resided at ~
3 E`~~'S ~~r F~ ~•-r- N-//~`3~. Nowever, 1 have changed my domicile to
(Street and Numbet) S ~
and am and have been a bona fide resident of the State of Florida since ~ day of
~ , 19_.~ and 1 reside at 2- ~r ~A N ~v ~
( tteet and Number)
6~ 7 1' T• L tL r S t. Luc ie County, Florida,
,
~c~~y)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inseri here any pertinent facts, such u sale of property or business, or relinquishment of empioyment at fo~mer
domic~e, remoral of family to new domicile, purchzse of home, rtc.)
. HOMESTEAD EX~MPTION:
ENTERING CHILDREN IN SCHOOL.
If entering children in school,
please list their.names:
~
A.:;
FIL'~0 A!~~ RECORDEO ~Ly
ST.l.UC1E ::~UNTY FIA. 4~
' ROCE ~ ?O~TRAS
CIEFK C :~UIT COURT
' - RF~Q~:. Vr:F ~iEO
i
' Mar 9 I 4s PN'7~
~1~4s
I FURTNER CERTIFY that t will register at my local address when the registration books reopen, and
comply with all other requiremcnts ot a legal resident of this State.
I FURTHER Ct:RT[FY that 1 have no intention to•return to my former domicile, and I intend to remain in
.f' T L, ~C C~ ST . LUCIE • County,
Y- ~ i - ,
Florida, pcrmancntly. cc~tr> ~
.1•~h~y o c h I
~ - S IGI~IATURE
.
w . .
Swtiril~to~~Md su cribcd bcfore me this day o!'
,
_ A. D. 19 74 1 ing re s s
.'~-~~ROGER PO~T r CLERK CIRCUIT COURT , Florida
. :~v` ` -:`~e ut Clerk 600K~~.~ ~~E 864
gy~..~ r P Y
~ (To be ex uled in duplicalr anJ unginrl filyd ~+'ilh Clrrk Circuit Coutl, and Juplirate wilh Taa Assesfor)
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