HomeMy WebLinkAbout2864 Declaration of Domicile and Citizenship
TO TtiE: STATE AND COUNTY TAX ASSESSOR. ~
ST. LUCIB CpUNTY, FLORIDA: ~ -
71iis is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in
accordance, and in conformity
with Section 222.17, Florida Statutes. ~
~ 6~~~ ~c~..~. ~ f-~ . ,s ~ '
1 was formerl~r a legal resident of _..l~_~~~ , ~f--- /-XQJ and I
(c~~r) (siae.)
resided at ~~'~3~- A . However, I have changed my domicile to
(St~eet sod NumOet)
and am and have been a bona fide resident of the State of Flortda since day of
~i~.. ,
19 2~ , and I reside at ~~~-s` ~
~ (Street ~ad Number)
~~~~~F ,,.1~ ~~:1 County, Florida,
(air)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inserc here anr Per~ineee fsccs, such as sale of property o~ Ausinas. a~ rellnqutshment ot emplormrnt at tormer
domic~le. remoral ot familr to new domicile, purcfiase ot home. ete.)
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school, - -
please list their names:
(`~P.t/~ _ _ ~~ix~. ~~~~1~
1
fIlEO 4!+L~ ~EGaR0E0 ~
ST.IUCiE ~~uHT FLA: .
ROGER ~~~tTR S G
CLERK CI~CUIT URT
F.ECOR^ 1f°.c~!ED
AUC I5 IO OS AH'7~1
~ - - ~
~
~ ~ 289506 '
~
a . .
~
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with aU other requirements of a legal resident of this State. •
1 FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
) ~ ST. LUCIE , County,
Florida, permanently. c~'1r)
~ ~~z.L.-~ Q' ~tl/. /[~~i j nx l -
~ -
. • :o ~•Y i . .
"-.~y~a?Iru.~ur~~i':,~~=w•.wi:
~s ` . rt t . ~
ii~~p \ n L L~ y j t' ~
4~ J~~ ~ .
.1 ??U~~.l ! ~t.~': :
:~yyqi7t~{~~l:su t before me this ~day of ~ .
~ ~
_ 3~;' ~ A.D. 19.~~. f c ZL ~ ~
-t~;.
. _ -
; Florida
~~e~~f- ~.ctie.~- .
- ~ ~ ~ ~ ~ _
- ' ~,.~tt'~~
~ By ` Deputy Clerk
~ , d00K ~.JU PACEzO~
.
~ _
nt~r~ i: •
~~x ~ _ _ _ ~ _ _ _ _ ~ - ~ : ' i_*..... ~ -3 ~ r ~L x~~ !
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