HomeMy WebLinkAbout1387 . . • ~ / ~r
Declaration of Domicile and Citizenship ~
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TO Tt1E STATE ANU COUNTY TAX ASSESSOIt, 2H~186 ~
ST. LUCIE __COUNTY, FL.ORIDA:
, i
This is my declar~tion of Domicilc and Citizenship in thc Statc oC Florida that I am Piling this day in '
accardance, and in conformity with Section ~22. i 7, Florida Statutes. ~
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1 was formeriy a legal resident of ~_~C , • ~ and 1 -
(~~r) tStste A
~/~~cj : However, I have changed my domicile to
resided at s-
(Street and Number) ,
and am and have been ~ a bona fide resident of the State of Florida since /.~Z'~ day of
. r:
, 19~y and 1 reside at ~ L`~ ~ ~ p ¢
s-~' a/ 7~~ ~su~~.pa N~~+e«~ ~
~ ' _ _ County, Florida,
9 • (citr) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Florida.
(lnsert Aere any pertineat facts, such as sale ot ptoperty or business, or relinquishment ot employment at formtr
domic~e, removal ot family to new domicJe. purchase uf home, etc.)
ENTERI"IG CHILDREN IN SCHOOL: ~I. NOMESTEAD EXEMPTION: ~
If entering children in school, .
please list their names:
i
f LEO Ah;, RECOROE~__
~UC~E COU~tr Ft~. ,~a
ilOCc"~t POITR~S j ~
CLERK C~i:CU1T COURt ~
REC~R[ VfRtFtEO~~..~.~
E ,lt~ I i 12 0~ PM'1~1
; .
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. ~ ~8~.86
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 CERT(FY that 1 have no intention to return to my former domicile, and I intend to remain in
~ ST. LUCIE County,
,
Florida, permanently. (~'`r~
.
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Swor~?~taE~(d~-~~ib~'frb~d:bgforc me this day of
' . ~~~t~~', pG.'-~.,.
- -A.D. 19 74 _
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' '~ti,._=" ~ - % : - , Florida
P _ _
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By'~~ ~~`ti~~. r'.` ~~~c ~~?lL puty Clerk .
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