HomeMy WebLinkAbout0209 Dectaration of Dor~~cite ana c~~j~zensn~p
"1'O THE STATE ANU COUNTY TAX ASSI:SSOR, 2~5520
ST. LUCIE _COUnTY, FLORIDA:
Tiiis is my dcclarati~~n cf Domicitc and Citizcnship in thc Statc of Florida th~t 1 am tiling this day in
accord~nce, dncl in conformity with Scctio~ 2~2.17, Florida Statutes. ~
1 was formerly a legal resident of , ~ and 1 ~ ~
(Citr) (st ts) j,
nsi~ed at r~ -~J~- • However, I:iave changed my domicile to ~
(Street an Numbet) ' 1
and am an~ have bcen a bona fide resident of the S!ate of Florida since ~~ay of ~
i~ n P_ , 19~ and I reside at 7 ~ Y~~ ~
(Stteet aad Numbet) ~
-_~Yt. ~Q~ n ~~)C 1 ~ _1~C~t~,,,_--__ County, Florida, ;
(C~ir) . ~
and this statement is to be taken as my declaration of citizenship. actua~ iegal residence and domicile in the State ;
of Florida.
(Insert here anr pa~tinmt facls, such as sak oi propertY or business, o~ relinquishmsnt of employn~eat at tormer
domic~le, temovsl of (amily to new domicile, purchase of home, etc.)
ENTERI*?G CHILDREN IN SCHOOL: a. HOMCSTEAD EXEMPTION: ~
If entering children in school,
please list their names:
,
~ ~ .
~ FI~EO Ati~ CORD~p' v
~
Si.CtfCtC OUM)7 t1A.
ROGER ITRAS
CLERK Ct"~ CQURT
RECORC rfP,:FtEO
Ju~ 1T 10 3~ ~l4,.'-'~I
~ . 2~~
~
~ 1 FURTHER CERTIFY that I wiU register at my local address when the registration books reopen, and
~ compiy w~ith all other requirements ef a legal resident of this State. .
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I in:end to remain in
~Qr ~y ~ l~~. ~ e, ST. LUCZE Caunty,
(c~ir) ~ '
~ ~=lorida, permanently.
~ ^ / ~~'l. c
~ •
~ G[/~'~vd M_. c{ A s~
~
~ Swo o,~~rtsubscribed before me this 7 day of
~ :~r~''• ~ /~~7 ~P f
~
' ~ A.D. 19 74 ~
' ••lk• I j~ 1 ~ ~l 1 . ~ l~~l 1 Florida
R PQ~~ CLE llIT_CflI1RZ- ~
, ` r
g~• ~ Deput~ Clerk
t , ' " : BOOK PAGE ~V9
~ 'CO.~
F
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