HomeMy WebLinkAbout1379 ~ ~ i :
Deciaration of Domicile and Citizenship ~
TO THC STATE AND COUNTY TAX ASSESSOR, ~ iZ~OS
ST. LUCIE CpU~Y, FLORIDA:
'fliis is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in~
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~P~S~o ~ , V I~P NiA and I
1 was formerly a legat resident of ~~tr) ~sae.~
3 t,/ t~ fie SN ~ V ~ 1?G _ . However, 1 have changed my domicile to
reseded at ~ N~~~
~ day of
and am and have been a bona fide resident of the State of Florida since
u uS7~ 19~., and I reside at n4 ~ lt7 A/~oSO ~V~ •
, ~sa~es~..a Nw.e.~) . -
O,~-~ ,~u o i~ _ S-~ ci l'ic County, Florida,
(~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
Florida. ~
uid~meac ot smpio~nueot st tormec
(lemt bae asr Pettinent facts. snel~ as sale of prope~t7 a~°~
~ do~aicile~ ~emwsl of hmilr to aew do~aic~7e. P~chase of Aoae, ete.) -
HOOL: HOI~STEAD EXEMPTION: ~
ENTERING CHILDREN IN SC T~.
If entering children in school,
please list their names:
~~iar~~v ~E~~~ ~eellivPp.
f~A ~Ll-eu ~~~ac,e ~ _
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Fi~fa ~?~+r ~~c~eofo
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R~Gf ~~~~iTRAS ~
CL£~K Ci :CC~i COUAT
sECrR~ ~=:J
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I FURTHER CERTIFY that I will register at my local a edress W?hen the registration books reopen, and
~ comply with all other requirements of a legal resident of ttus S
I FiJRTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
c 1 ~ ~ ST. LUCIE , 'County,
~
(cnr)
Florida, ~a~atl~t: _
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~ ~~tk~~'~=` ~ me this ~ day of
~ Swp~1}:~~Atl'd_~!~~~'~fore
.
L ~ `tl~ `
~ A.D.19~_
~ ~ , Florida
~ ROGER _ - -
~ g Deputy Clerk .
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