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Declaration af Domicile and Citizenship
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7'O T}Jl; STATI's A;~II) COUNTY TAX ASSCSSUR, ~
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ST. LUCIE , ~;OUNTY, ~LORiDA:
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'Il~is is my dcclaration ot Domicilc anJ Citixcnship in thc Statc of Florida that ! am filing this day in ;
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accordance, and in conformity with Scction 222.17, Florida Statutcs. s
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! was farnierly a legal resident of ~ v A NS ~ ~S„«~
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,uK v~S; ok ~2 A p~. A . However, 1 have changed my domicile to
rrsidcd at ~.4~~ ' }i
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anci am and have becn a bona (ide resident of the State of Florida since S+h day of ; R~
S NrZ;s~. ~3
A~•S•t~t- - 19~4 and ! reside at ~~y ~ { ~ . ~Pfi• -
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St. Lucie County, Florida,
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aiid this statement is to be taken as my declaration of citizensl~ip, actual legai residence and domicile in the State
nf Florida. ~
(Insert hcre any pertineot facts, such u sale of groperty ot ~~~siness, or telinquishment of employment at tormer i~~
domicile, removal uf family to new domicile, purchase of home, etcJ ;
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. HOMESTEAD EXEMF'TION: ~ '
CNTERING CHILDREN IN SCHOOL.
If entering children in school, ~ - ~1
please list their names: , ,
D, E!. ~S'
~~~{a~ ' ~•tS~E~!,~t l~. 1 ~
~NtG 1 l~ S~ . N:= ~
5.,~ p~~c v; sc ~ o F P' ~t
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~~p ;~~r~ .Z ?~d~a iv~y ~-~~f~ }
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fI~EO aK_~ kECO~~ED
S7. LUCI~ ~OU!!tY F~A. .
- ROCFR F"vITRAS
CLERt. C+'.~UIt COURT
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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 CERT[FY that I have no intention to return to my former domicile, and I intend to remain in
ST. LUCIE County, ~ ~
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~ Florida, pett~anently:,;;.• tci~r) _
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" - ,;c.~;-=r. - ~IG TURE
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Sworp.~tQ_and~~~ed before me this ~ day of , ~
l A.D. 19 74 gl~l ~.,~NR; ~F ~ Ivo ~#_3 <
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ROGER ~ TRAS, CLE K CIRCUIT COURT E , Florida
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; g CQt. ' Deputy Clerk
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~ (To executad in duplkale and origina) fded with flrtk Circuit Coutt, and duplicate with Tsz Assessor)
~ eoeK230 PacF1727 ~
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