HomeMy WebLinkAbout2913 . . ~ ~ ,
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Deciaratian of Domicile and Citizenship
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"TO "f~lE STATE ANU COUNTY TAX ASSL'SSOR, ~~2 ~
_ ST. LUCIE _CpUNTY, FLORfDA: . ,
Tf~is is iuy .i~cZaratian af Domi;,ilc sr.d Citizenshig in tlie tiaic~ o~' Florid~. that 1 am filing this day in
accordance, and in conformity with Section 222.17 Florida Statutes. ~ ~
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[ was formerl a legal resident•of ~~,l~~'~ , and 1
~ y / (CiIY~ (Slate)
resided at ~ ~ owever, I have changed my domicile to
(Stree and Number) ~I~j '
and am and have been a bona fi resident of the State of Fl 'da since day of
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, 19~_, and I r~side at
(Sttest aad Nu ber)
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~ . County, Florida, -
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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 Flarida.
(Inse~t here anr pe~tinent faets. such ss sale of property w busirKSS. or ~elinquishment of ~mployment at former
domic~le. removal oi tamilr to new domicife, purcAase ot home, etc.) ~
ENTERING CHILDREN IN SCHOOL: Q. HOMESTEAD EXCMPTION: ~
It entering children in school, ~
pi ase list their names:
Ff:.E~? te~. - f~~?.DED ~
. fT.t1Y~t :.y13111Ttr fLA. ~
~::.~=s = i131lS
JIT CCl1Rt •
Fft^r;,, ,`~'.ftc~
Aac ly 316 P!~'7a ~3
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' 28.9552
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I FLJRTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with aU other requiremen~s of a legal resident of this State. ~
I FU THE CE IFY that I have no intention to return to my former domicile, and I intend to remain in
~ ST. LUCIE County,
~ P~ ,
~ ~lorida, permanently.
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~ `Sw?o ~ ~`a#oi~~~ub9v~ before me this day of ~
_ .:~:~,t~~ d~,~,o,~~w D
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~ • A.D. 19 74
_ , ' 7~ / i~°;~1'~ , Florida -
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By Deputy Clerk .
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