HomeMy WebLinkAbout2345 Dectaration of Domicite and Cifii~~nship
TO Ttil: STATI: ANU COUN"1'Y TAX ASSL:SSOR, ~8~~43
~ST. LUCIC __C.OUNTY, FL~~lDA: ~
'Iliis is my drelaration ot l)omicilc and Citizenship in thc Statc of Florida that 1 am filing this day in
acconlanc~, and in conforniity witl~ Section 222.17, Florida Statuies. ~
1 was formcrly a lcgal resident of ~'1 and 1
(citr) (s~.te)
resided a1 ~~y~ ~-t ~~'Q . However, 1 have changed my domicile to
(St?eet snd Number) • ~
and am and have been a bona fide resident of the State of Florida since 2`~~ day of
~ r~
19.~ and I residc at 7S~ 7 ~ ~~-Q-Q 1-
- ,
(Street and Numbet)
~..t:~~v~~ . O ~ ~ ~ . CQe~niy, FlQri~a,
(citr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(inseri here any prtiinent facts, such as sale of pruperty or business, or te!'snquishme~of employmrnt at tormet Y
domic~le, removal ot family to ~ew domicile. purchsse of home, etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: a
If entering children in school,
please list their names: .
~ ~.G~~ ~1 ~ G~c~~z
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f~lEO,an:h"t~ORDEO 4 ~
ST.IU~~~ ~~UKTY fLA.
. • aQ~{ ~ -0~1RAS
CIE~K JIT COURT
RECCPC :CO .
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I FURTHER CERTIFY ihat 1 will register at my local address when the registration books reopen, and
comply with all other requirements Qf 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
3~ ~ y~~~ t~~ ST . LUC IE , County,
,
Florid,a,.Qet7}~anently. (c<<r)
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~ ~S~+irb~to~~'d ~~ribed before me this -1~_ day of r,
;~,,.t ^,~'`"~j 7 .!~C~i;~ X ~S a a . _
~ ~ A.U. 19 7~. ~IA~Z •
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ROGE P~TIRA~_SLERK_~I8~U1T~IIllgT- 3''~y ~~'~~2'~ , Florida
~
By t~~Deputy Clerlt
6~~ PA~ii ~
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