HomeMy WebLinkAbout2911 z ~ ~
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~ ' ' itizenshi ~ : '
Declaration of Dorr~icile and C p
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~ro THC STATE ANU COUNTY TAX ASSL'SSOR,
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ST. LUCIE COUNTY, FLORIUA: , ~ ~
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This is my Jccta~~ti~~~ of Dc~micilc and Citizcnship in the State of Florida th~t I am filin~ this day in
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accordance, and in conformity with Section 222.17, Florida Statutes. _
t was formerly a legal resident.of ~C~~,K~ , .~,\0.~o,•n.~ and 1
tcilr) (St•te)
resided at ~.1~ ~ . However, I have changed my domicile to
(Street snd Numbet)
and am and have been a bona fide resident of the State of Florida since ~~t~ day of
, 19~~, and I reside at ~
(suK~,~a
` ~ \ ~ s, ~ ~ County, Florida,
~Or ~\e~c~ u ~e_
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lnxrt Aere anr pertinent tacts. such as sale ot propMy or Dusiness• or relinquishment of employmeet at torma
domic~e. removal ot tamily to new domicJe. purchsse of home. ete.)
ENTERING CHILDREN IN SCHOUL: ~ HOMESTEAD EXEMPTION: ~
If entering children in school, .
please list their names: '
;
~a~~ Q ~ ` ~ `
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- tFtlLO ~i' •~c:+~£iDED ~
ST.LUC.i ~,,;~'~ilS~ ~ ~ i
Cl R
rV ! i COURT ' ~
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- A~ 1~ 2 3a PH'?y _
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~ 289550 r
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
~omply with aU 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
~ ST. LUCIE
~ ~U~~ ~ ~ QY e~ . - , County,
Florida, permanently. cc+~r)
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' ~IG'FrA'
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° bef re me this ~ day of
Sworn t~};" b~d Q
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-c • . v< a~~,
A.D. 19~_ ~L~~~
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~~r~ \Qr~-~ , Florida
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By ~ :ti Deputy Clerk
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