HomeMy WebLinkAbout2892 Declaration of Domicile and Citizenship
TO THE STATE: AND COUNTY TAX ASSGSSOlt,
, ST . LUCIE , CpUNTY, FLORII)A: ~~2 •
'Il~is is my dcclaration of Domicilc and Citizcnship in the State of Florida that I am filing this day in
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accordance, and in conformity with Section 222.17, Florida Statutes.
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I was formerly a legal resident of ~u 9J ~'i e
t-~ (citr) (St.te)
resided at 70 5~ CLja ~Cf{~~ ~ 1` d- . However, I have changed my domicile to
(Sireet and Numbe~)
and am and have bcen a bona fide resident of the State of Florida since day of
~u» e , 19~~ and I reside at ~ ~ ~l r"°~''~' ~ .
. . (Street sod Number)
~p y ~ ~t - L ct c i ~ _ - ,C~t a County, Florida,
(cxcr) '
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lasert here any pertineat fscts. such as sate ot property or Susiness, or relinquishmeat ot employment st formet
domkle. cemoral ot t~milr to new domicJe. purchase ot home. etc.)
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school,
please list their names: - -
~H~~
G_ ~
G~*-.,J ' -
fIL~D Aru ?ECOR 0
ST. Luc1i CuDl1iY ~
ROCER F:11~R~S
Ct£RR C:F.r,~~~T COURT
RECORD %En•FicO
' ' - Auc 19 I15S A!~'7~1
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~~L ~ ~,c~~1 ~ ST. LUCIE , County,
~
Flarida, permanently. cc~~r) `
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~ ~ -s.~`r, %'1~~ 30 ~ NSO N ~
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~ Sw~4 and sub~~'ibet~ before me this day of 3~s ~:~~~~~-~-~-~J ~
~ • - A.D. 19~~.
~ ~ T lRT ~ e~ v -c`~cJ , Florida
ROG -
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By Depul:y Clerk
. . . a R ~:JO PACE~O~1
BOOK
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