HomeMy WebLinkAbout0855 Declaration of Domicile and Citizenship ~~.~3
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TO THE STATL• AND COUNTY TAX ASSESSOR, -
ST. LUCIE _CpUNTY, FLORiDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
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- ~ - " °-'L c~__.•~_ ~f~f'1 1'f Fl...;.io CfaN~tPC_
accoraance, anu u~ w~iivii;~,.y w :
1 was formeriy a legal resident of o~ ~~3~~P~~S ,~ASS'. ~~~3 and I
_T tcrir) (st.ce)
~ A ~r/m e f'P-/' /t cQ . . However, I have changed my domicile to
residcd at
- csaeee snd xumeer)
and am and have been a bona Gde resident of the _State of Florida since ao~ ~tJ4~ day of
~1 / XI e~ A Nc~ ~ r~ ve~
, l9~ and I reside at ~~3 3`$' N~~~)
F rC P~ _ ~t ~ I+iG C'~ - County, Florida, ;
(cur)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
~f F~~rida.
(Inxrt bere anr Pc*tinent facts. such as sale ot propertY or business, or relinquishmeat ot emploYmeet at torma
doa~icle, temoral of tamily to new domicila. Purchsse of Aome. atc.)
RING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTI~Ns ~
ENTE
If entering children in school,
please list their nemes:
~ ~~;r~~ ~M ~.S A~m
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288143
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ST.IUCIE COUItTY FIA. i
P.OC~R ~OITRAS .
CIfRK C1:<<.UIT COURT
RECO~~ YEk:fIE~~..~-~
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j ~o s 25 aH
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements 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 remain in
~-t ~~,c ~ _ ST. LUCIE , 'County,
Florida, permanently.
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S.~.'to 'nd•subscnb~e,d~ before me this ~ ~ day of 333 ~~I~~
o,,. . ,Q%X~~ AN v t
c A.D. 19~~ '
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~ f ~ ~G ~ , Florida ~
,~OGER _ ~TRCUIT cn~RT
gy ~,~,,C~~G ' Beputy Clerk
~ bOt~c~ P~GE
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