HomeMy WebLinkAbout2716 Declaration of Domicile ~nd Citizenship
'I'O Tll~ STAT~ ANU ('OUN7'Y TAX ASS~SSOtt, 2~~(~~~3
ST. LUCIC _ COUNTY, ~LORIUA:
1l~is is my drelaralion of Uomicilc and Citizrnship in thc Statc of Florida that 1 am filin~ this day in
accordancc, and in conformity with Scrlic~~~ 2~2.17, Florida Statules. ,
1 was formrrly a Icgal resident of ~~~t
~r..~.~e~..d , and 1.•~
(Citr) (St~te)
resided at ~?~,-~~~2~s~~^ . However, 1 have changed my d~micile to
(Sl~eet and Number)
and am and have been a bona fide resident of the State of Florida since day ot~
- .
f 3~'• , 19-~, and 1 reside at
~ (Street and Number)
,
, County, Florida,
(c~cr)
and this statement is to be taken as my declaration of citizenship, actual tegal residence and domicile in the State
of Florida.
(Inxrf here any perlinent facts, sucA u sale ot propetty or busineu, or relinquishmenl ot employment ~t tormer
domicJe, removal of family to new domicile, purchs~e of home, etc.)
ENTERING CHILDREN IN SCHOOL: ~ liOMFSTEAD EXEMPTION: ~
If entering children in school,
please list their -hames: ~
~c~~$3
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1 FURTHFR CERTIFY that I will register at my local address when the registration books reopen, and #
~ comply with all other requirements ef a legal resident of this State. ~
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I FURTHER CERTIFY that I have no intcntion to return to my former domicile, and i intend to remain in
ST. LUCIE County,
,
~ FIo~~..Qcrmanendy. cc;~r~
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~ Sw~rn~to~d'subs~:ribed before me this day of ~
~ ~ - A. D. 19 74 '7 9'Z .~~~'~~5* r ~ ~
- ~ 3
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~ ROGER TKA~ CLERK ~IR~UIZC.QUR~ ~ ` - , I'lorida ~
B ~~<~-Q-. Deputy Clerk .
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