HomeMy WebLinkAbout2868 Declaration of Domicile and Citizenship }i
28'7443 ~
TO TNE STATE AND COUNTY TAX ASSESSOR. •
ST. LUCIE _ CpUNTY, FLORIUA:
This is my declaration of Domicilc and Citizcnship in the Statc of Florida th3t I am filing this day in :
accordance, and in conformity with Seclion 222.17, Florida Statutcs.
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1 was formerly a lcgal resident of / ~ %
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resided at ~ D G L S ~ tii iQ vc . However, I have changed my domicile to :
~suee~ .pa x~meK~
and am and have been a bo~a fide resident of the State of Florida since day of f
, t 9~y and 1 reside at ~ T J~
(Stteet aad Number) k
I ~ / ~ ~ G ~ ~ A, • u ~ ~ s: County, Florida, ~
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of
Florida.
(lasert Aere anr pertinent iscts, sucA as saie of propertr ot business• or relinquisAmeat of employmeot at tonav
domicile. remoral of tamily to new domic~le. Purchase ~f home. etc.)
~-~~RING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names: 2~4~3
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CLERt, ;;:{.yyyT COlqtT
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I FURTHER CERTIFY that [ will register at my local address when the registration books reopen, and ;
comply with aq other requirements af a legat resid'ent of this State.
I FUR'IHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~ ST. LUCIE `
, ~ County,
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(Citr)
Flond~„~ri}1~nent~,y:,
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Sworn to' subscribed before me this -zZ day of ~
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A.D. 19~4-.
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s~L,~" ~ ~,.-,.~.t ~ , Florida 3
ROGER POI~RASj~C1.F~K CIR~LITT Cn 1R~_
` B ~~~-G ~o-~ ~Gt~ Deputy Clerk ~ i ~
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