HomeMy WebLinkAbout2906 . • • • • •
Dec{arat~on of Domic~ie and .C~t~zensh~p
TO TIiE STATG AND COUNTY TAX ASSCSSOR,
ST. LUCIE _ CpUNTY, FLORIDA: ~~S ~
This is my declarati~n of l~micilc and Citizcnship in the Statc of Florida that 1 am fding this day in
accordance, and in conformity
with Section 222.17, Florida Statutes. ~
~
1 was formerly a Iegal resident of . ~d I
' --1~_' tstaa) 1
resided at ~ N~-~`~-~-"` '~,-.-~owever, ! have changed my domicile to
-w~ (Street aad Number)
and am and have been a bona fide resident ot the State of Florida sinoe ~ ~ day of
, 19-., and I reside at ~ ~
(Street a~d N~wber)
~~Z'~ ~ ~ ~ County, Florida,
(c~ir)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domic~e in the State ~
of Florida.
- (Inseri here any pertiaent fscts. suth as sak ot ptoperty or businas. or rd~n9ui~w~ewt ot eaPb7we~t at totaK _
doa~ic8e. cemoral ot familr to aew domicile, purc6ase of Aome, etc.)
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~
~
If entering children in school,
please, list their ames:
. i~-~ '
~ o yn_.~c~
~"/,-y ~
, - . ~ .
. r~e~s
s~_wac ca;w~~t,~.
~ itoLEa +~o,T~s
- - ~t~?t t:., ~::.;a1T ~ ~
~'EC~:~~ Y~~ °FlF~~~„~
~ Ar~ t9 ! s6 PM'l~
; .
~ .
~ .
~ ~ 289~545
¢
1 FURTHER CERTIFY that I wiU 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 1 have no intention to return to my former domicile, and I intend to remain in
~ ~i~ ~ ~ ~ ST. LUCIE , County,
Fiorida, permanently. ~~"r~
. ~ -
, ~ ~ -
~
~A r ~3Ndr e Itil ~~s.Pcs %E~'S
~ -
~ w,,.'
Q~M~~r~
Sv~ei~•tg ~t :'bed hetore me this l day of ~ .~Z~~~
~ ~ _ f~/
- • .v`~.a' ~ . ~T
: A.D. 19 74 "
• : . y. ~
s~ - ~ - ~ Florida
.h ;i ,
Y - " - _
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3 ~ ~ ( x' I
' Deputy Clerk
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- . ao~~0 ~29U5
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