HomeMy WebLinkAbout1706 . . • • • ~ ' ~'i
Declaration of Domic~le and Cit~zensh~p ,
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"1'O TIiE STATG AND COl1NTY •rnx nss~:ssoK, 2ag'746
ST. LUCIE _ COUNTY, r•~oRieA: y~i
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This is my dccla~ation of Domiciic and C.iti~cnship in thc Statc of Florida that 1 am filing this day in
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arcordancc, and in conformiiy with Scction 222.17, Florida Statutes. ~ ?
was focmerl a le al resident of , ~~`S'~ and I
1 Y ~ (sat~) ~ k !
tct~r)
S- SU l~~~L~ ~QD/~f? . However, 1 have changed my domicile to
r~sidcd at ~ a '
(Street and Number) Z- r
and am and have been a bona fide resident of the State of Florida since l- day of
~ U E-- 19~ and I residc at ~ .S 4~Tf~ 3%~` S~rt
ti ~ (Street and Number)
~ ~ C , St . Lucie County, Florida, , ~
(~~r) ~ ;
and this statement is to be taken as my declaration of citizenship, actual legai residence and domicii~ in the State :
of Florida. ~
(Inseri here any pertinent facts, such u sale of pro{+ertY or business, or relinquishment ot employment at tormer ~
domicile. removal of iamily to new domicile, purchau ot home, rtc.)
• . HOMESTEAD EXEMPTION: ~ i~
ENTERING CHILDREN Ih SCHOOL.
If entering children in school, ~
please list their names: ~
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~!~,~iS1 s~NN 7~h~~~~/~'/y
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FllEO ahl~ RE~~ i~ ~
$T. CUCii CO~~i~~ • ~
AOG=F. rOi~RA; ~ ~
ELERK C! :CUIT ~RT ;
_ qcr,~:~ll Yc f',flEO.~.~.~ 3
l~e l ~ ! k~ PH'~~
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288'746
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1 FUR"THER CERTIFY that I wiil register at my local address when the registration books reopen, and ;
comply with all other requirements of a legal resident of this State. ~
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I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in ~
ST. LUCIE County, {
Fo ~7- ~1 C _ _ ~
Florida, permanently. cc~tr)
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~ IGNATURE
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~ S9~rbrrt tb and s~~~ed before me this day of ,
; 't c:q}" 74
~ ~ ~r. A.D. 19
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~ RpGER-- 0~ `S CLE K CIRCUIT COURT , Florida ;
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~ g ' Deputy Clerk `
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~ (To be e:ecuted in duplicate sod original filyd with Clerk CircuN Court, snd duplicate with Taa Asseswr)
SOOK ~O PAGE~ / V5
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