HomeMy WebLinkAbout2907 ' . • • . • • • • "1 ~
Declarat~on of Domicite and Citizensh~p
_ _ ,
TO THI: STATE AND COUNTY TAX ASSESSOR, ~~s '
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ST. LUCIE _ COUNTY, FLORIDA:
This is my dtclar~tion of Damicilc and Citizcnship in the State of Fiorida that 1 am fiiling this day in
accordance, and in conformity with Section 222.17, Florida Siatutes.
I was formerly a legal resident of ~ o' ~ ~ and I
' ~Ly~y (st,te)
resided at 6~ ~~~c- kS~1~ L ~ . However, I have changed my domicile to
(St~eet and NumAer)
and am and have been a bona fide residcnt of the State of Florida since day of
, 19~ and I reside at
(Sttett aad Number)
~ ~J~ r' ~ y, c ~ _ ' County, Florida,
(~~r) -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~
(Idsert Ae~e sor pertinent facts, such as sale of p~opertr or businas, or relinquishment ot employmeat at tormet
doo~k7e. removsi of tunily to new domieite. purchsse of home. etc.)
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school, .
please list their names~ _
~~t, c~.. ~ ~ / . ~ ~Z Cr / J1-~ -
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r~ ~ l Q- h~._ f
/ lY L l G~ `L C. / + -
fILEO AK~ ~EC~xDEO .
=T.IU~IE ~OUNTY FLA.
ROCE.; r~~~~RAS
CLEfK CIO:L'Jit COURT -
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I FURTHER CERTtFY 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
~ ~ j~ ~ C ~ ~ ST. LUCIE , County,
u (Ciir)
Florida, permanently. •
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: ..g'" ~p~to and ~n$ed before me this day of `3 ' S / ' ~ ~
;.{~=;~d . ,.,~~Q•':~' ~
~ ~ ~ A.D. 19_7__4_~ , FT1~L
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_ R ~'oy~T ~~yr~ ~ , Florida
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By Deputy Clerk
: • BooK 230 ~?r~ 2~9Q6
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