HomeMy WebLinkAbout0218 . -
Declarati~n of Domicii~ and Citiz~nship
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'I'U TIIE STATE AND C'OUNTY TAX ASSESSOR, ~~~~8
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ST. iUCIE COUNTY, FLORIUA: ~ `
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Tt~is is my dcclaratiun af Domicile and Citi~cnship in /he Statc of Florida that 1 am filing this day in R
accordanc~, and in conformity weth Sectic~n 222.17, Florida Statutes. ~
1 was formerly a legal resident•of N X~~~ and I
(cfer) (sae~)
n:~ided at 1~ S 2- 1~ r`> > r~ . However, I have chanaed my domicile to
(Street and Numbe~)
and am and have been a bona fide resident of the State of Florida since T~-~ ti L~- day of
2 , 19~ and I reside at ~11 7 S~ b 1~' ~ f ~
(Street and Numba)
r_' C~ S~ 1 Cw 1~r . _ County, Florida,
r ~ . ~ a
(c.titr) .
and this statemcnt is to be taken as my declaration ot' citizenship, actual legal residence and domicile in the State
af Florida.
(lasert hue aar perlinent facts, sucA u sale of propertr or business. or telinquishment of emplorment at tormer
domie~e, ~emoval ut familr to new domicile. Purchase of home, etc.) _
ENTERING CHILDR~N IN SCHOOL: HOMESTEAD EXEMPTION: ~
If entering children in school,
glease list their names:
-:r' e ~ ~ -f ~ r.:~-
T ! C ,C.l~!.r /S c : e" ,
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fl~f y:.• ~ if:..:~[If! f
sT. L!>. : ;..t11: l' FIA. ~ '
I F:•~~%. - .~-~AS ~ :
~ CL ~ i: : CUiiR1 i
k F£_.~3=; :r-. ^'r~ ~ ,
I
Arc [ I I 3z PH '~~I ~
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289'74L~ ' ~
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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 requitements 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
1 ~
~ e v,E v~ ~ ST . LUC IE County,
Ftorida, perman4~t~ - cc~~Y)
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2'st t . ~r _ . _ y .
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Swa~~tOY~~;~~bi`~~~$ec+~before me this day of ~ c ~~t t ~
- r . K : 4`, G,
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~ ~ A.D. 19~ ' ~ ~
:t~.a1; ~ `i- ? ~ ~'T /~?C P f
ROGER P Florida
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By Deputy Clerk ;
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. ~00~~`31 ~;E 2~.8 ~ ~
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