HomeMy WebLinkAbout0533 :
DeclaratiQn af Domi+ci~~: and Citizen5hip .
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"I'O TNf: STAT~ ANU COUNTY TAX ASSL:SSOR, `
S'r. LUCIE _ COUNTY, FI.ORIUA:
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This is my dcclaration of Domicilc and Citizcnship in the Statc of
Florida that l am filing this day in ~
accordance, and in conformity with Scction 222.17, Ftorida Statutcs.
1 was fom~crly a legal resident.of ~ and 1
- (ci~r) ' (si )
resided at ~ I Q~ . However, I have changcd my domicile to
(Street sad Numbcr) r ~
and am and have bcen a bona fide residcnt of the State of Florida since day of
, 19~~ and 1 reside at ~~-3 '~t"' -
~ (,~treet and Number)
N~~~.~ County, Florida,
- (citr)
and this statement is to be taken as my deciaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert here aay pertinent facls, sucQ as sak of property or busiaess, ar rrlinquisAment ot employment at tormer
domicie. temorai o~ lsmilr to aew domicik, purchase of home, etc.)
ENTiERING CH~LDREN IN SCHOOL: ~ HOMESTEAD EXEt~fPTION:
If entering children in school, .
ple se list their names: ~
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F~IE~ R4~ RECUR~EO V'
ST.LUCIE COUNTYFLA. ~
ROv: ?~ITR~S ~
I CLERi C:.t~,,i~IT COUR ;~cj
~ P.c~n•~C r~f i'ED
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A~ [3 12 oz PN'1~1 ~
28~~84
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I FURTHER CERTIFY that I will register at my local address wh~n the registration boaks reopen, and
comply with all other requirements of a legal resident of thi~ State.
1 FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in
~1~~ ~ ~ ST . LUCIE , County,
Ftorida, permanently. «'`r~
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Swo~ to and subscr{~~efore me this day of ~~i Q ~ t
CL.~ `
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• • ` 1 f: ' 'r ~ _ A. D. ~ 9_L'^L__.
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RO~ER ~P ~ VI~~~_ , Florida
By ~ Deputy Clerk .
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