HomeMy WebLinkAbout2564 . . v.
Deciaration of Domicile and Citiienship
. ,
'1'O'1'f1E STATE ANU C'OUNT1' TAX ASSL•:SSOR, ~9,~~.86
- S
ST. LUCIE _ ~OUNTY, FLORIDA: -
This is my dcclaralio~ of
Domicilc a~id Citizcnship in thc Statc of Florida that I am ~ling lhis day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
1 was formcriy a Icgal ~sident of ,~~~y~ , ~S~~~e~ • and 1
i
resided at ~ . However, 1 have changed my domicile to
~ (Street and m r) - }
and am and have been a bona Gde residcnt of the State of Florida since day of
, 19,~, and I reside at
. , ( and Number)
~ County, Florida,
(~cr) ' -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inscrt here any pertinent ixts, such as sale oi propertr w business. or relinquahment of employment at former
domicde, removal of family to new domicile, purchase ot 6ome, etc.)
.
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EX~MPTION: a
If entering children in school,
please list their names:
,
~ : ~
~~~EO ~cc:wr~
'$T. LUC~` : ~UMT~'~.
, R~(:_ ~V'TRlS t~
` CIEF!i GC~
j cc ~n:_.~ . 'tL(~
' AY~ I~ J~ ~ AN'1~1
f
E
~
~ V
~
~ -
~
1 FURTHER CERTIFY that I witl register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTH CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
ST . LUC IE County,
~r - ~
~ Florida, permanently. tc~~r) ~
. > • -
~Y~i,. ~
`~j~i~.~~.iy.'~,+, _ .
~ r~' ~
~ .
~'~;C.U 1; ` ' : ~ '
, ~
~ ~ ~ . . • , .
.d-. .•a~•-•.. -i~ .
:~i\i ; .CdUU e~ a
.__~~"s . ~ - -
~ :'~i:~'"~~~"'~,.~I~r~S:.
~
~ r'i." ~ • i. ~
~ ; s.
t~'; • ' ~
S~^' ' C ' ~ ~
~ S~ro o:and~ttBac~Gcd before me this ~ day of !
-
. ~ , •
~ . ~ :
r A.D.19~_~ ~ -
~ ~ ~~~..r+~ , Florida
ROG~R ~P __~~r~I,ERK~IRCiITT .O ~B~ --e - - ~
~
ny Deputy Clerk
.
~ ' BOOK ~ ~ ~
~ ~
~
. ~
.
~z ~ - - -L ~ ~
.a~:~"N .v'--2t."';`r . -~^n_~.._. _ .,.~e _ . , ?t,~ ~ 'v ~ . ~