HomeMy WebLinkAbout0522 / '
. - . . . . ~ . ~i
Dsciarat~on o~ D~micite and Cit~~en~~1~p
_
289g'?~ ~ :
"TO T1iG STA7'E AND C'C~UNTY TAX ASSESSOR, '
. ~
ST. LUCIE CpUNTY~ FLORlDA: ~ `
- ,
This is my declaration of Daniciic and Citizcn~hip in the Statc of Florida that 1 am filing this day in ~
- . ~
+ 4
accordance. and in conformity with Section 222.17, Florida Statutcs.
. • e~~J
1 was formerly a leg~t resident ~of e ~v~ - , and 1
(cicr) (State)
rzsided at ~ re.,~-~4~ • . However, I have changed my domicile to
(Street aad Number)
and am and have been a bona fide resident of the State of Florida since ~ day of
.Tk.tie , 19 and I reside at ~6 3~ s~~''~M ~ r'ST
(suK~.pa N~~+en)
. c e , 5~~~+c. e Couaty, Florida,
(A~r)
znd this stetement is to be taken as my dc tion of citizenship, actual legal residence and domicile in the State
of Florida. ~
(tasert here any pe?tinmt facts, such at sak of p~opertr or business. or ttliaquishment ot emplorment st tormer
doonicile. nmorsl ot tamilr tp new domicJe. purchase ot home, etc.)
~NTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION: ~ -
If entering children in school,
please list their names:
~,~dA,~ /1~~',~`/~esf ;
,
3"ud ; ~il.l. ,Ul `,F,~ ,P~s~ ~
~,ri~~~~"~ f~~~ , ~ .
F/LE~ ~.£;;~g0E0
ST.LUCi~ ~~:'i~rF
~ =~i~ -:,,~$14. G
orr ~ r-. . rCUR7 ~
_ Aac 13 l i~4 AH 'l ~l
~8~~~
,
. ~
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and ~
comply with aU other requirements ef a leg,al residen: of this State.
I FURTHER CERTIFY that 1 have no intention to return to my fo:mer domicile, and I intend to remain in
ST. LUCIE ~
~~e ~ , County,
Florida, permanently. ~~i~''~
• G 1~ _
~ " ~
~
,.,.ti~~..:.:.,;,
j,~ , ; .
j~: - -
• ~
Sw~t~.~o and sub
.s~rlbed before me this day of
. ~Y _ ~ ~ ,...5-u , sT' ;
~ T ' ~ - .t'r A. D. 19~~. 7~ZL ~
3 ~ - i.~ ~ , Florida ~
~
RbCE~:. -
p. ~ ~ .
. .
By Deputy Clerk ~ P
t
~ d00K~~ PAtiE RJ~.+~+ • ~
- ~
A(~C~ T - ,
~-:r- _ ~ ~ ; - - - - ~
, ~ c'~`.,~.,~
~ ~ y:,-~~~. N~;~vrs. ~ ~ I~~ _e.~_ E_