HomeMy WebLinkAbout1121 Declaration of Domici~e ana ~~~~zensn~p
~ 2851'7~
TO THE STATE AND COUNTY TAX ASSCSSOR. -
ST. LUCIE GpU~y, FLORIDA: .
'Il~is is my declaration of Domici{e and Citizenship in the State of Florida that 1 am Cling this day in ~
accordance, and in conformity wilh Section 222.17, Florida Statutes. ~ ~
~ ~v~ U~ - " N'~r'bA„~ and I • ~
I was formerly a legal resident of ~~~r~ • ~y~~«~
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resided at 6SO`~ NA'~' ~~'vE _ , However, I have changed my domicile to
eser~se snd xumeer) ~
and am and have becn a bona fide resident of the State of Ftorida since day of ~
(~E~FNg~~ , 19 and I reside at 36a s U~~QaN~me~)
~T- P~F~'c E , 5 T. Lvc~E County, Florida, ;
(c.ti~r) t
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
tdomic~le emovai ott
amilr otnew domicile. purchase ot home, et
j.«~linquishmeot ot ewplo7meut at fotma
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school, _
please list their names: •
~lop~~~;v F~~ ~
S~ Na~dt~S•~S~~P
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' f1Lfq Ah ~4UMTY
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ST.LyC~~- z~„ja?S
c~~i'ci-~.+~~1 couRt ~
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2g61'71
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1 FURTHER CERTIFY that I will register at my local address when the registration boeks re~pen, and
comply with ali other :equirements 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 ~main ~n
_ ~ ~>,E,~c ~ _ - ST. LUCIE , County,
Florida, permanently. . . tc~:r~
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~ day of
Sworft- ~ ~,~.fid'3u~s~t~~~before me this -
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~ - -~c ' A. D. 19 74 -
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~ ~ ~ 4~ ~ ~ TR~i]TT c.ntntT , Florida
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g~.; ~ } Deputy Clerk
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