HomeMy WebLinkAbout2413 Declaration of Qomiciie and Citizenship y~
7'U THE STAT~ AND COUNTY TAX ASSl:SSOR, {
ST. LUCIE ~ CpUNTY, FLORIUA: ~8~ ~
'il~is is my declaration of Damicilc and Citizcnsl~ip in the Statc of Clorida that 1 am Rlnig this day in
accordance, and in conforn~ity with Section 222.17, Florida Statutes. . , ~
~v and I
1 was formerly a legal resident of ~ ~
(City) ~ (State)
resided at ~ . However, I have changed my domicile to
• (St~eet and Number)
and am and have bcen a bona fide residcnt of the State of Florida since day of
19~ and I reside at ~ 3 G
' ~ , (Street aad Nurnber)
~ .l-c~ ~-.c.- County, Florida,
,
( tr) -
and this statement is ta be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Imert here anr pertineot faela. such as sale of property or Dusiness. or relinquishment of employment ~t tormer .
domicle, temoral of family to new domicJe, purchare of home. ete.)
E TERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
N
If entering children in school,
please list their names:
~
, -
f D ~+k^ ?~L~Af!
~ ~~CsE C~ ftiJ1. ~
ItOvE4 ~f~tT~?yS 1----
- _ CtEi?« C:f:~JjT SOtl1if
" Rff: Rt1V£~::~'~,
AYC f+l 10 ~1 AM'7~1
I
~ - 289~8'~' ~
I FURTHER CERTIFY that I will register at my local address a?hen the registration books reopen, and
comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
~ - ST. LUCIE County,
,
Florida, permanently. (~'~r)
ZGa. G~it~./~c.. - _
_ ~
_ r , t „ti
. . ~ `J ' • f FI
. _ _ - .
~1.~~~~,.eO:. .
` ~ ; ~i-=
. ~ '+.~'K~~
G~~ ~ /
; 5worrt; :~'scribed before me this ~ day of ~
:
. . ~ : 3 c ~ I ~
.
. • ~ A.D. 19_~ -`F~TLI ~~3
~ ~ ~..~~L~s , Florida
06ER ~ g~UST_~IIUBZ
By ~ Deputy Clerk ~
600K~t7V PACE~~~~
, - -
_ _ . - tT_.~..
- _ - ~ -~y.::.k, . . y •
• ~ ~ ~~~i•Y'f"'ne~~~~ X St-
S~i~+Y`~~~'.~!~ ~~j3 e~i:,
. a,~f~1~~~~~~$'~'~~ . . .~ka . _ .