HomeMy WebLinkAbout1091 Deciaration of Domicile and Citizenship ~ p
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TO THG STATE AND COUNTY TAX ASSCSSOR,
ST. LUCIE COUNTY, FLORIDA: ~
71iis is my declaration of Domicilc and Citizcnship in the Statc oi Florida that 1 am Cling this day i~ ?
accordance, and in conformity with Section 222.17, Florida Statutes.
1 was formerly a legal resident of ~A~A w~N ~ NEw ~~'h and I •
(cyir) (sau)
resided at ~ r "~S 7/y/~t1S T~R o~4 ~ . However, I have changed my domicile to
- ~St~ee~ .na N~meK) 7~/f
and a nd have been a bona fide residcnt of the State of Florida since ~ day of
~c 0 e r~Q 19 /,J + and I reside at ~'~Oo~~oau~rRy (l~1RoE~/f~ANE
~ tsa..~.aa N~~ee~)
~/~~R _ ~ c/ c i~E County, Florida, t
tc~tr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Iascrt hcre aar pertinent tacts. sueh a sale ot propertY o~ business. o~ teliaquishment ot emplorment ~t to~mer
domic8e. removal ot familr to new domicile, purcAase ot Aome, etc.)
ENTERING CHILDREN IN SCHOOL: II. HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names:
s~~uciE cou ~rT°r
ROCf R F~OITRAf
' C~EflK CtRCU1T CWRT
i . RFCORD VERIFIED
i .
' . . M~ t3 9 4~ AM'1~i
~~3'R 920
I FiJRTHER CERTIFY that' I will register at my local address when the registration books reopen, and
comply with all other requirements of a tegal resident of this State.
I~~F~RTHER RTIF hat I have no intention to return to my former domicile, and I intend to remain in
~ ° ST . LUCIE
;f.=r~ / L-'/c' C ~ , COUntY.
~ . `tltly. . (citr) ~ F/P~d c~iC' iC _ pG f/~~'~
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ribed before me this ~ day of ~
';'?+Jet~i+r.• ~ ' ~ ~U ONN9R aR KN E
~ ~ A.D. 19 74 -
ROGER ~ % iE~'~.~ , Florida
gy ~ Q' puty Clerk
~ BOOK PACE 1~~9
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