HomeMy WebLinkAbout0510 ion of Dormiciie and Citizenship
Declarat
~1'O "t'li~ S1'ATE AnU CUUNTY TAX ASSESSOR, '
ST. LUCIC _ ~UN1.Y F1.ORIUA: ~8~~1'
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This is my dccla~alion ot Domicilc and Citi7cnship in the Statc of Florida that 1 am filing this day in ~
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accordancc, and in confornuty with Section 222.17, Florida ~tatutcs. . y
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1 was forn~erly a legal resident ot
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resided at ~ T~ ~L K . However, 1 have changed my domicile to c
(Street and Number) ~
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and am and have been a bona fide resident of the Statc of Florida since ' - day of
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, 19~y and I reside at ~ ~O ~ ~~~~g- ~ -
~ (Street and Number)
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~~i iA ~ ~ ~ ~C-~'~ D COUTit~l, Florida,
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and this statement is to be taken as my declaration of citizenship, actual leg~l residence and domicile in the State
of Florida.
(l~sett hete any pertinent tscts, such as sale of propertr a busincss• ot re{inquishment ot employment at tormet
danicle. temoval of family to new domicile. purcAsse of home, ete.)
ENTERING CHILDREN IN SCNOOL: ~ NOMESTEAD EXEMPTION:
If entering child•ren in school, -
please list theiyy/~/I na~~~.//~y~/QQ~`//~~pp.' s: ,
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K
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_ iitEO aNC :~E~OROED • tr
fT. LUi~t ;,OUHT1' FLA.
Ra~.:~ r i 0?'RAS ~
~LEkK ~'";Gi~tT ~pURT ~
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4 ~ C3 i l 2s AN ~ -
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I FURTHER CERTIFY that 1 will register at my local address when the registration books reog~n, and
comply with all uther requirements of a:egal resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in #
ST. LUCIE Count , ,
s~ "'~f'~~~.~~(~~,.. ~i- , Y
Fiorida, permanently.
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g~vpiir !~i and-s}r~r~bed before me this day of !
~ ~ ~ ~ A.D. 19~~_ i ±
ROGGR P _ , Florida <
By ' ~,~a,N,~ Deputy Clerk ~
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