HomeMy WebLinkAbout0806 ~ ~
i n of Aomiciie and Citizenship
Declarat Q . .
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7't) TNC STATE ANU COUHTY TAX ASSt:SSOlt, 2?.~1.SO
_ ST. LUCIE CpUNTY, FLnRIDA:
This is my dcclaration of Domicilc an~ Citizcr~ship ir. ti?e Statc of Florida thal I am filing this day in : F~
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ac~ordancc. and in conformity with Scction 222.17, Florida Statutcs. ~
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1 was fomnerly a lcga! resident of , and I i;
(citr) ate) F ;
' . However, 1 have changed my cl~micile to ~,~j
residcd at ~ ' -
(Sttett aod Kumber) - ~
day of • ~
and am and have bcen a bon3 ~de resident of thc State of Florida since
A./~~ ~ i
, ~ 9~~, and 1 n~side at ~ ~ ~ ` ;
(Strtst aad NumOer) ~
SC . Lucie Gounty, Florida, ~
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State •
of Florida. _ ~ ~
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(Inxr! Aere snr pertinent tacls. sucA u sa~c of p~opertr or bcsiness, or relinquishmeet of emplormeni at former - ~ ~
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domiciie. tcmoral of familr to new domicile, putcnase ut home. ete.) ~ ~
HOMESTEAD EXEMPTION:
LNTERIt~G CHILDREN IN SCHOOL: ~ ~
If entering children in school,
please list their names:
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- x - ~A~ -~y =T.LUCIE COIEiNTYRftA. ' ~
~ ROGER. POITRAS ~ °
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~ _ A~c 1~ 9 5z 111'7~1
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I FURTHER CERTiFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIrY that I have no intention to return to my former domicile, and I intend to remain in
, ST. LUCIE , County,
~ ~ ~ -
Florida, permanently. <~~~r~
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' Sveorri to an ''bed ~efore me this day of .
; - . ~ -
, - ~ A.D. 19 74 ~O~ i ng ~ O ~ _
. . _ `•.Ez~ 'rtr ~r'~'
;~p~~?, p . ; CLERK IRCUIT COURT , Florida
..t.•• . ' .
' . ~ .~,y
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s ~ _ Deputy Clerk
(To pe «uted in duplicate aod wiRioai tJed ~+~ith Cierk Cireuit Court. ~nd dupficate with Taz Assessor)
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