HomeMy WebLinkAbout0557 ' micile and C~tizens~i ~ I
Deciaration of Do p .
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'fU "fl1E S'TATF AND CUUNTY TAX ASSL-:SSOR, .
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ST. LUCIE _ COUNTY, ~LORIDA: ~ t •
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This is my dcclaration of Domiciic and Citizcnship in the Statc of Flarida that 1 am filing this day in '
accordance, and in confarmity with Section 222.17, Flori.~la Stututes. ~ ~
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1 was formerly a Icgal resident •of ~~~as ° , ~P X Q S and I ~
(Citr) (St•ee) ;
residcd at ~ hca ~u• . Howevcr, I have changed my damicile to
(Street s~d Number) ~
ancf am and havc been a bona fide msident of the State of Flarida since day of -
_ ~1 Q~_ , 19~ and 1 reside at ~ ~ y ~a'v'~~~'
(Street sad Number)
~f . , - a~u-r County, Florida,
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and this statement is to be taken as my declaration of ci;izenship, actual legal residence and domicile in the State
of Florida. , ~
(Insert here art~ pertinent facts, sucl~ ss ule of propertr or business, or relinquishmeat ot emplolrment at totmer
domic~e. rcmoval ot tsmiir to nevr domicile, puctAsse o[ home, ete.)
IN SCHOOL: IiOMESTEAD EXEMPTION: ~
ENTERING CHILDREN Ll
If entering chi~dren in school,
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please list their names: -
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E~ ~r_ = ~;.;.~KO~o
ST. LUCac i~)JN~Y FV{_ n
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CIEP,K ::;-~,~r~OURT 6
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1 FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, and
c.omply with all other requirements of a legal resident of this State. ~ ~
I FURTHER CERTIF hat I have no intention ta return to my former domicile, and I intend to remaia in ~
ST . LUC IE , County, ~
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Florida, permanently. (c'`y~
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Swo~t to and before me this a"~L day af ~
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• A.D. 19~~_. ~ ~
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~~'•-f,,. , Florida
ROGEIt "P~ ~
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t3y Deputy Clerk `
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800K P~l?l ~ ~
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