HomeMy WebLinkAbout0305 Qeclaration of Domicile and Citizenshi~
;
~
"1~0 7~liE S1 A1'E ANU ('OUNTY TAX ASSI:SSOR.
ST. LUCIE __CpUNTY, FLORIUA: ~'~~95 `1
11~is is my declaration ot Uomicilc and Citizeizship in thc Statc of Florida that 1 ant Cling this day in
~
accordance, and in conformity with Section 222.17, Florida Statutcs. ~ ~
~ ~ ,
1 was formerly ~!egal resident•of a~k - and I
T~ (Citr) ' (51ate)
r~ sidcd at ~ f~`' • However, I have changed my domicile to
(Sheet and Numbcr)
and am and have been a bona fide resid~nt of the State of Ftorida since ~ day of
\1 o ~ , 19.~, and I reside at ~~-T-,~.~rt.~
(Street aad Number)
~ ~ 7`~ ~~2~ , ~..C~~ a County, Florida, -
(atr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
~f t=lorida.
(Insert Aere anr perli~ent tuts, sucA as sale ot p~ape~ty or business, or relinquiihmrnt ot employment at tormer
domicle. remoral of famiiy to new domicile, purcAasc o[ dome, etc.) '
ENTERING CHILi3REN IN SGHOOL: ~ HOMESTEAD EXEMPTION; ~
If entering children in school, ,
please list their name :
. ~
~
; -
;
~~E~:.. .
SL ~ DE6
' :.riMTlr f~A_ ~
- . r~s ~
_^Cl~~!,r. _ . ~~iiRT
- A+~c ['L 11; 06 AM '7~ ~ ~
_ ~
289'~95
~
- ~
i
~
I FURTHER CERTIFY 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
~~~q~~ ~ ST. LUCIE , County,
Florida, permanently. (c~~r~
. ~y')' _ ~
Z je- ~
~ ~ ••t~
/ +
a~fes.: ~ i ~'E,~a
~ .•`'gG~II f i'~?: C •rti'. ;
~
~ ~ ~i y. i
• ~
5~ . -
:r. ; ~ ~ "P~-~~: ~
_ r. Q ;w .
= ~ i;~?; . i . _ ~
S~voFri ~~~~~subscri~ed;be`fare me this day of ~ ~
7~0~
" L`'%` - ~~~.~1`'i: ~.C:- ~ ~
. C-' A.D. l 9~_ F~AILZ ~ ;i
_
, ~ ' ~ r ~ . ~ . C~ ~~2.~ ~
RocER ~~r ~ ~ciTT c~tiRT Floriag ~
- ~ ;
By~'' Deputy Clerk 0 Q
gooK~31 ~ ~05
~
.
,
-
- - - - - - -
x,.~;~ ~ ; - - , z r
~ ~ -
" . . _ .