HomeMy WebLinkAbout0846 ~
Declaratian of DomiGite and Cit~zenshi~
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"fU '('lll: S'fA~~E AtiD COUNTY TAX ASSI:SSOR~
ST. LUCIE ~~~'~s - t
COUNTY, FLORIQA: °
- This is my dcclaratio~i of Domicilc and Citi~cnship in thc Statc of Florida that 1 am filing this day in
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:~ccordancc, and in c~nforn~ity with Section 222.1 Florida Statutcs.
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I was fornicrly a legal rrsident of ~ C ~f ~ and I
(c~tr) (state) w :
residccl at . Howcver, 1 have changed my domicile to
(Stteet and Numbcr3 ~ '
a:~d sm and l~ave beere a bona fide nsident of the State of Florida since ~y day of
~i _ , 19~~L., and I residc at ~,~C ~~i~'ls''Q Co~R ~ .
(SUett aad Numbet)
~~~R` t , St . Luc ie County, Ftorida,
~c~~y)
;~nd this statement is to be taken as my declaration of citizenship, actual leg~l residence and domicile in the State ~
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of ~lorida.
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(Insert here sny ~tinent (xts, such as salr of propertr o~ business, or relinquisDmeat ot employm~~t at former ~
domlcile, remoral of family tu aew domicile, purctux ut home, etc.)
. HOMESTEAD EXEMPTION : ~
ENTERING CHILDREN IN SCHOOL._ ~
If entering children in school,
please list their names: ,
~~1~ ~O u~1',F /Ci~AHco.Fl~~
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fILE~ AND RECORpEO
ST. ttlC~~ COUNTr fLA. ~
ROCER POIT~iA~ '
CLERR C:ZGiJtI GOURt
Rf~nRO VE?+ftEO-
A~s 11 I I 46 AM'1~1
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~ 1 FURTHER CERTIFY that 1 wi:! 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 CERTIFY thai I have no intention to return to my former damicile, and I intend to remain in s
` ST. LUCIE County,
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Florida, permarieniljr. cciir)
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; : ' . . : ~ ~ S IGNATiIRE
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Swotn"'.t~~rid.su't~~~~fore me tl~is Y .
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' ~ A.D. 1 ~ 74
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ROGER PO RAS CLERK IRCUIT COURT , Florida
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gy Deputy Clerk
(To be e:e.uted in duplicate snd oriSinal tied with Ck~k Cirtuit C~arf. snd duplicate with Ts: wuessor)
D~Vn F~1Vi ~ ~ AGri 1,. r. - I : i '
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