HomeMy WebLinkAbout2250 Declaration of Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE CpUNTY, FLORiDA:
This is my dcclaration of Domicile and Citizenship in the State of Florida that I am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. _ ~
1 was formerly a legal resident of t'~~ 51~' /o^'~ and I •
(Citr) (stab) .
nsided at 'y~ ~A Q~ ~ S t~ e~~ . However, I.have changed my domicile to ~
(StreN and Number)
and am and have been a bona fide resident of the State of Florida since ~ 7 day of
o~~` i~ SV ~ N1e r- /Q o a c(
/Yl L; , I 9~ and I reside at ~~~1 ~od NuanDe~?
~Jt . ~ L u ~ / ~ t~ ~r .R ~ ~ County, Florida,
(CitY)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lasett hae sny pertinent facts, such as sate ot propertY o~ business. or relin9aishment ot employmeat ~t tormer
domic8e. remoral ot bmily to ~ew domicile. Purchate ot home. etc.)
ILDREN IN SCHOOL: Q HOMESTEAD EXEMPTION: ~ •
ENTERING CH
If entering children in school, _
please list their names: ,
c.. ~ir~.~ ~/n. t l7'I. /~e w . ~
S s A... h~ w, ~r
~ L/ Z~i' f~+ A• ~P w~ FILED AHO RE~pRDEO
sT• LUCIE COUNTY F~~,
CLERK
C
~CUIT COURT
RE~ORD vEFiF~EO.~
'
~ 11 10 ~9 AN'l~l
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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
S1~ ~i~ ~ J e ~ ST. LUCIE , County,
rmanently. c~tr~
Florida, pe ,
,
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~rn to and s~bscri~~d before me this y day of 1, ~ G a~
~ 7/ S rr er /Q
r~ ~ ~ ? ~ ~ ~ A.D. 19 74 -
~J f ~j S~~ 1s
~ i ~ O~. ~Cu e i~ , Florida
R • . .
gy puty Clerk
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