HomeMy WebLinkAbout0799 1
D~cl~rat~on of Domicife anu Citizenship
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TO T11C STATE AND COUNTY 7'AX ASSESSOR, 2~SS~~ i"1`
ST. LUCIE _COUNTY, FLURIDA:
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'iliis is my drelar~tion of Domicilc and Citizenship in thc Statc of Florida ihat 1 am Piling this day in
accordance, and in conformity with Section 22~.17, Florida Statutes. i. .
) nn~~ ~~/~'r ~ r~-_ ?~5~ ~ and I
1 was forn~erly a legal resident of ~~~r~ ~ ~
~i~t i~J~1 ~^Yl ~ . However, I have changed my domicile to
resided at . ~
(Stteet and Numbe~)
~ S day of •
and am and have bcen a bona fide resident of the State of Florida since
I 010 ~-~fh ,~,Lc r ~ ~
9~_, and I reside at ,~su«i .~a N~~eK)
`~n ~ J~~~lt l C., ~ County, Florida, ~
~CQhL'E~ .
cc~tr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. •
(Insert hete anr pcrlinrnt facts, sach u sale ot p~opetty or business, or relinquishment of employmcnt ~t tormer ~
domic~le. remoral of family to nrw domicile, purchase o! home, etc.)
ENTERII~G CHILDREN IN SCHOOL: II. HOMESTEAD EXEMPTION:
If entering children in school,
please list their names:
FlIEiJ dh: = ~J4v
ST. tOC?i :,r;~Hiy FLA 4r
. R~GfF i ~:TRAS
~~E'= ='~?T COURt ~
R~rn.;•, . ra
Ju~ ~ 2 23 PN
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with aii ~ther reyuirefnenis ef a!e~! re~ident ~f this State.
I FURT~iER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
`~G~ ~ Zc~ ST. LUCIE , County,
Florida, permanently. ~~~`r~
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S~vorb,t~'a~d su6s
A~~efcfre me this ~ day of
. ; ' ~ . ~ ~ C'
` % ` >•'~.`i~,~` ' A.D. 19~_. ~3'3
` s • ` . ~iG l ~ [ C_ i
['_C Florida
!_R EtY''P • ' - _
, ,
gy Deputy Clerk
_ - ~ pA6E
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