HomeMy WebLinkAbout2702 . . . . . t' -
Declaration of Domicile and Cit~zenship
285102 ~
. ,
'TO THE STATE AND COUNTY TAX ASSESSOR.
ST. LUCIE _COUNTY, FLORIDA: ~ `
This is my declaration of Domicilc anc! Citizeuship in thc State ot Florida that ! am filing this day in +
accordance, and in conformity with Section 222.17, Florida Statutes. ~
l/,l' ~ti and 1 ~ ~ i
I was fotmerly a legal resident of ~~~y~ ' ~,ee~
T~ z~S ~ . However, I have changed my domicile to
resided at E: .
(Stteet and Number)
and am and have been a bona Gde resident of the State of Florida since Tday of ~
FeQ , 19~~, and I reside at J~~? f-'l e c~if~A A!~ ~
_ (Streel and Number)
~i~l ~ ~ .~l ~l~ ~i e . S%
- ~ ~ _ ~ County, Florida, ~ f
(c~~r) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Florida.
(insert Aere anr pcrtine~t facts, sucA as sale ot ptopettr or business• or retiaquithment ot employment at twmer
domic~e. removs) of family to new domicile, purchase of home. etc.)
ENTERING CHILDREN IN $CHOOL-: _ HOMESTEAD EXEMPTION: ~
~
If entering,children in school,
please list their names:
/~C1 ~v ~d~'o ~c/ lrlQd~i.~ m 285102 ~
ftlEO Ayt? AECOROE~
ST.~UGE ~UtJ!!7T flA.
- ROC~~ POtTttAS
CIEk~ C~~~CUIT COUAt
qt~ORE~ YEi'tF1ED ,
- ~ 1~ IZ a2 PH'1~! ~
~4 ~
~
~ .
~
~ • ~
~
~ -
~
I FURTHER CERTIFY that I will register at my tocal address when the registration books reopen, and
cQmply 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
~
j ~ ST. LUCIE County,
~ (citr) ~
~ Fiorida, permanently.
~ ~ " ~ V (I~ ~ • '
i'~: - • ~ . ~ `~j ~ •
~ . ~1., . ' ~I ,C/r~•/~ ' ~ V • ~ L~
' ~ G ~
. ~f ~ ~ ~ ~
~ ~ = a~ ~ -
Sr~ro~;. 's~~~nbed before me this day of
G
• ~ A.D. 19 74 -
R R POITRAS, CLERK GIRCUIT C~~IRT_- ~ Florida
~ g ~.t.~C Deputy Clerk
~
. 600K2~8 PACE~~ .
~ n~.t~ ~ . : - ~
r : - - - ~ r~ ~x~.
- -
~ " ' I x~~
..~.,,~~~~€S~:-~~z~_~.._ ~.f ~ . ~ .,a _ ~c~~=~ ~a _