HomeMy WebLinkAbout0292 Dec~~ration of ~omic~ie and C:~tizensn~p ~ ;
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"I'O Tl ll: STATE: AI~U ('UUN7~Y TAX ASSI:SSOR, ~ ~
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ST. LUCIE __COUNTY, FLOR11)A:
'Iliis is my dcclaration of Domicilc ~nd Citizcnship in thc Statc of Florida that I am Gling this day in ~
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accordancc; and in conformiry with Scction 222.17, Florida Statutes. -
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I was Cormc~ly a Icgal ~esident of , ~ • and I
lcitr) tstace)
r~sided at However, 1 have changed my domicile to
(Street srtd Number) a-~~ '
and am and have tx:en a bona fide nsident of the State of Florida since day of
, 19~ and 1 residc at J~rtS ~ ~
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(Stteet and Number)
' ~ S~ / i, c ~ County, Florida,
i ~+2.. 1 .
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and this statement is to be taken as my declaration of ~citizenship, actual legai residence and dor:iicile in the State ~
of Florida.
(Insert here any perlioent fxts, such as sale of property or ~usiness, or relinquishment of emploYm~nt at former
domicle, removal ot family to new domicile, purchur of home, etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school, `
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please list their names: =
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FILEO ~N4 RECUitUEO F,~
ST_ LUCIE CaUNTY f~A. _
ROGE.°, PGtTRAS
CLEKK C:s:CUtT COURT r .
RFC!1R[~ Y:P,F~EO
1l 4 iz PH'1~I
~~45583
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1 FUR?HER CERTIFY that 1 will register at my local address when the registration books reogen, and
comply with all other requirements ef a legal resident of this State.
I FURTHER CERTIFY that [ have no intention to return to my former domicile, and I inte~d to remain in
r-~ ST . LUC IE , County,
Fiorida, permanently. tc~~r)
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Swostl.io and sub'scribed betore me this ~ day of ,
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. A.D. 19~~ ~L
_ ~ Q~L~_ , Florida
ROGER
,_~r~~LER~ ~ T -
gy~`? ~ ~ v~~ ~ DepuLy Clerk
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