HomeMy WebLinkAbout1629 r
~ ' ' itizenshi :
Declarat~an of Domicile and C p
.il
1'O TIIE STATE ANU COUNTY T/1X ASSl~SSOR,
ST. LUCIE ~~0 . j.~~
_ COUNTY, FLORIDA: ~
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"(7~is is my d~•claration of Domicilc and Citizenship in thc Statc of Florida that ! am filing this day in
,
accordancc, and in conformity with Section 222.17, Florida Statutes.
1 was formerly a legal resident of ~~~s , and I ~ F
St~te)
resided dt L ro w ~r~~ *~it~' • However, I have changed my domicile to .
(Street snd Number) ~
and am and have bcen a bona fide resident of the State of Florida since _ day of
~r 19.~~", and 1 reside at ~r
- ' (StrKt and Num ) ~
~O I~+r I/a• A.~?~ , sr ~.v E- County, Flarida, ~
(~~r) ;
and this statement is ta be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert here any pertinent facts, such ss sale of property or business, or relinQuishment of employment at tormet
domic~7e. removal ot family to new domicile, purchase o[ home. ete.)
ENTERING CHILDRyN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names:
fIIED x!1~ REGOROEO
St. LUCIE COJNTY f~A.
ROCE~ s'~~+RAS Li
C~ERM G~~UtT COURT.~
NEC~~~ Y~ ~:'rIEJ.,~.~
;
i t3 IU 33 ~M'1~
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284~50
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I FURTHER CERTIFY that 1 will register a~m~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
ST. LUCIE
w, f+~• ~/1~~,~ , , County,
~ (citr)
~ Florid~;•pe'rinancntiy. _ ~
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~ Sworn to and subscribed before me this day of
~ go~ s. L T~~~ ~ I z.-
~ A. D. 19~_.
~
~ ~,r / , Florida
~ ROGE P TRA D[?R~
~ .
By Deputy Clerk
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