HomeMy WebLinkAbout2603 Declaration of Domicile and Citizenship
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TO TIIG STAT~ AND COUNTY TAX ASSI:SSOR, 28930'~
ST. LUCIC _COUNTY, FL.ORIDA:
This is my d~claration ~f Dc?micilc and Citizcnship in the Statc of Florida that 1 am tiling this day in
accordance, and in coni'ormity with Section 222.17, Florida Statutes. . .
~ ~~a,,c~ ~ ~ ~ _ and I
1 was fornicrly a Icgal residcnt of ' s~a«~
(ci~y) (
resided at ~aQ . owever, I have changed my domicile to
~ (Streel and Number)
and am and have bcen a bona fide residcnt of the State of Ftorida since day of
, 19_~., and I reside at ~ ~X O 1'1 C~ UP , '~7~ l.~~
, (Stteet and Number)
' ~ , 33~ . « ~ ~ e- County, Florida,
(cti~r) ~
and this sfatement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inserl hete sny pertinent facts. such as sale of propcrly or busioess, or relinquithment of emplorment at (otmet
domicile, removal of family to new domicile, purch e of home. etc.) -
HILDREN IN SCHOOL: HOMESTEA~~EXEMPTION: ~
ENTERING C
If entering children in school,
please list their es:
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,
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F LEp a:t~ ?ECOttDEO
~~-~UC~~ ~~UMTY fi,A. ~
a~c~~ :;,,ra~s
CLERK .,,c:,.,J;t COURT
°EC~?C vF~ ~ :ED
I~uuc i5 I s3 PH'7~1
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i 289~0'7
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I FURTNER CERTIFY that I wilf register at my tocal address when the registration books reopen, and
comply with all other requirements Qf a legal resi8ent of this State.
~%~RTHER CERTIFY that 1 have no intention to retarn to my former domicile, and I intend to remain in
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- ~ - ~`L~'- ~ t ~°~f ~ P _ ST . LUC IE County
: - . tly. (c~cr) ~ .
;Flbr'ida; perni':~~~ . i
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~ Sworn to and subscribed before me this ~f day of /^~1 " ~~~L ~~~'~~I ~
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~ , c s A. D. 19_~~ , .
~ ~ /~~2 , Florida
ROGER P ~~AK~IR~IIIZGQLIBT__ -d ~3 ~J`~7
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~ By . - ~Deputy Clerk
• BOOK ~ PA6E ~O~
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