HomeMy WebLinkAbout1069 Deciaration of Domicile and Citizenship
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~'O THE STATE AND COUNTY TAX ASSL•SSOR,
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ST. LUCIE COUNTY, FLORIDA: ~
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'Il~is is my declaration af Domicile and Citizenship in the State of Florida that ! am fiUng this day in
accordance, and in conformity with Section 222.17, Flo 'da Statutes.
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1 was formerly a tegal resident of ~ ~
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resided at ' P~V J . However, I have changed mY domicile to
(stn.c .oa H~me~.~ ~ ~
and am and have been a bona fide resident of the State of Flori a since ~Y ~ ~
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1, , 19-~ and I reside at r
t ~ae K.~eua)
(,l C 1 ~t • L- 1. P - County, F'loiida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domic~le in the State
of Florida. ~
(Insert here anr pertinent f~cts, suc1~ as sa~e ot propertY ot business, or retinquishment of emplo7seat ~ i~~
domic~e. remoYal of familr to new domicile, purchase ot home, etc.)
NG CHILDREN Ir1 SCHOOL: n. HOMESTEAD FXEMPTIUNs ~
ENTERI ,
If entering children in school~,
please list their names: ~~~!g'7"~
fiLEC sNG ~E~flil~.!
tT. LilWE ~3s~MTY fu
R;,b~~ ~31TR~S
CIERR w~.= CU1T t03iR1
RECnr(! YF?1~SE0~~..
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I FURTHER CERTIFY that I will register at of this Sta edress when the registration books rsop~en. ud
comply with all other requirements of a legal resident
I FURTHER CERTIF that I habe no intention to return to my former domicile, and I intend to remain in
~ ~ ST . LUC County,
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FIDnd~,:peri~agently. ` cc~~r)
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` S~vorn j and bscribed before me this day of ~ ~
~ ~ 4~y ~/i ~ 4? ~ V' .
~ A.D. 19~. ~
- ~ C~ P , Florida
RBGER P
gy ~~_~,./c,C', ~c `~•~eputy Clerk
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