HomeMy WebLinkAbout1709 Declaration of Domicile and Citizenship
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1'U 'l~liG STAT1: ANU COUNTI' TAX ASSESSUR, ~ ~
ST. LUCIE ~~~48
_CQUN"!'Y, FLC~RlDA~
'(lus is my dcclaration of Domicilc and Citizcnsl~ip in the Statc of Florida that [ am filing this day in - ~
, 2, 7 Florida S atutcs~
accordan~c, and in conform~ty wtth Sccttan 2~~ ~o Rt ll '
lc al residrnt of _ ~ - - and 1 ' ~
I was formcrly a g '
ici~r) (s~.i~~ ~ i
r~sided at ~ ~ . Howcvcr, 1 have changcd my damicile to
(Street and Number)
. • i ~nt of the State of ~lorida since day of ~ i~
R~
and am and have been a bona fide ns d
.
9 , and 1 reside at I D /U 2 F 4~ .
(Stteet and Number)
L~ St . Luc ie County, Florida, t
(citr) , •
ration of citizenshi , actual legal residence and domicile in the State
~?~d this statement is to be taken as my decla P ;
of Florida. ~
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(Inxrt here anr perlinent facts, such as sale of property or busineu, or relinquishment of emploYment at formet ~
domicile, reA~o~~al of family to new domicite, purchase of home, etc.) • *
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ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school, L~=1 .
please list their names: ~
j~t? 1~1v~.~ 1~1~` i'!~i ~ ~ ~
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FILEO t,Y;: ~c,~,)R~ p
, ST. LfIC,C :;UU47T f~A.
Rp~~F i•~tt~A jG
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~ pr.-,_-,~ =j~fl COURT
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2~g~48
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 1 have no intention to return to my former domicile, and I intend to remain in
~ C~ ST . LUC IE County,
,
Florida, permanently. (c~tr)
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= - S IGNATURE
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s~; ' ~t~ -
~L Syvotn .t4 an~.s~=~before me this day of . ,
~ • i3 " ,
~ ~ A.D. 19 74 ing r ss
ROGE~t POI'f S, CLERK CIRCUIT COURT , Florida
~ g 1 Deputy Clerk
Y -
~ ` (To be executed in dupticate and origin~l filed with Cletk Citcuit Court, and .iuplicate with Tax As.xssot)
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