HomeMy WebLinkAbout0865 Declaration of Domicile and Citizenship
TO TNE S1'ATE AND COUNTY TAX ASSL'SSOR, •
ST. LUCIE CpUNTY, FLORIDA: 288153 _
This is my declaration of Domicilc and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
.e . . r ~ I .
1 was formerly a tegal resident of ~ and 1
~ci~r) ~ (
resided at . However, i have changed my dvmicile to
(Suest and NumEer) ~
and am and have been a bona fide resident of the State of Florida since ~ day of
19~ and 1 reside at y
(Strett~umber)
~ ~ 1 ~1
County, Florida,
_T~
. (Ci~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
domic~e ~~emw~al ot taa~ilr otaew dom
~e purd~ase ~f om ~~~u~~~t ot emplormeat at tocma -
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names: ~
/1t rD1 1~
.
~
/IG~d~~~Gt~V C~~~~tCn't~N • ~ .
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F+LE~i aM!r 1'•ECDROEO
6T• ~ ClE ~GUMTY f1A.
ROCEF F~ITRA~
CLfRK G;':CUIT COURT
RECOR ~ V<<, ~ ;D
~IlL 30 ~0 56 ~N'7~
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I FURTHER CERTIFY that I will register at my loca! address when the registration books reopen, and
comply with all other requirements of a legal resid'ent of this State.
I FURTHER CERTIFY th I have no intention to return to my former domicile, and I intend to remain in
D~,,~~ ; a~~ ST. LUCIE , 'CountY,
-F~--~ ~~~y~
Florida, permanently.
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Swo r_s~E~~=~~efore me this ~ ~ day of
~ : %
- ~4 A.D. 19 7~+ -
c:,o;= ~L~p , Florida -
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$y ~ , Deputy Clerk
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600K ~O PACE 8~ .
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