HomeMy WebLinkAbout0654 • . . • . . •
Dectara~ian of Dornicile and G~t~zensh~p
. ,
TO THE STATE ANU COUI~TY TAX ASSESSOR, 2~59
ST. LUCIE CpUNTY, FLORIDA:
71?is is my declaration of Domicile and Citizenship in the State of Florida that 1 am filiag this day in~
accordance, and in conCormity with Section 222.17, F rida Statutcs. ?
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1 was formerly a legal resident of Q- and 1
~ n ~ ~ / (Citr) ~ (State)
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~sided at ~~'r, - . Howcvcr, I have changed my domicile to
(Street and Num4er)
and am and hare been a bo~a fide resident of the State of Florida since day of
, 19~ and I ~esidc at ~ ~ '
. t aad Nua~berj
G`- County, Florida,
(CS~r) ' '
;
and this statement is to be taken as my declaration of citizenship, actual legal m.sidence and domicile in the Sta~e
of Flarida. .
(Insrrl Aere anr pertinept faeu, such as salr of propMr or businas. or relin9u~nmeac ot emplorma~t forma
dominle, remoral ot tamilr to oew domicile. purcdase ot home. ete.)
ENTERING CHILDREN IN SCHOOLs HOMESTEAD EXEMPTION; ~
If entering children in school, .
please 1'st their s.:
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I FIJRTHER CERTIFY that I_will register at my local address when the registration b~oks reopen, and
comply with all other requirements of a legal resident of this State.
I FUR ER CERTIFY that I have no int~ntion to return to my former domicile, and I intend to remain in
~ ~ ST . LUC IE County,
.
Florida, pertnanently. c~'r)
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' day of ~j'D ~
Swo~rrta:~i~_;ubscti~~,-t5~cjre me this
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%~~i + ~ v'~ A.D. 19~ .
- - ~~rr~ ~ • ? '~~e= ~~G.r
ROGER~ ~ gI~ , Florida
By Deputy Clerk
a00~~71 1A~E ~
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