HomeMy WebLinkAbout1359 C~eclaratio~n of Donnici~e ar~d Citizenship
~os~8
'I~O THC STATE ANU COUN7~f TAX ASSl:SSOR. ~
ST. LUCIE .___CpUNTY, FLnR1UA:
This is ~z~y decla~ation of Damicile and Ci!izenship in the 5tate of Fiarida it~at I am ftlin~ this day en
accordancc, and in conformity with Section 2?2.17, Florida Statutcs.
• ~ SS ~~•le / and 1
I was formerly a legal residrnt of ~~%n y f~ e ICl ,
tci~1) (st.te)
resided at ~LQ 6 W~ ST N ~ G . Nowever, 1 have changed my domicile to
(St~eet aad Nua~bcr) -t
a:~d am and have bcen a bona fide n-sident of the State of Florida since L day of
, 19? and 1 residc at 1___L_L~~ ~d ~ N~R7H ~
- (suK~,oa ~~me«)
`7r ~f C~ e e . S f
~(,t C~ , P County, Florida,
(c~ir)
and this statement is to be taken as my declaration of cilezenship, actual legal residence and domicile in the State
of Tlorida. ~
3
(1~1 Aae aay pertincnt fxi~. such as sak ot property or business, or relinquishment of emploYment at former ~
domicile, remoral of familY to oew d~~micile, purchase of pome, etc.) ~
z
; i
E~ITERT'`?G CHILDRE*I Iy SCHOOL: NQMESTEAD EXEMPTIO'~:
If entering children i*~ school, ~
please list their names: ~
R ~c . i c ~v- ~
,
~t :
~~L~ . ~.G'o .C='-C~~ R~ ~
~l R ~tRC{I~~ ~
RE80R~ YERIFIFp~
- ~IN'~ ~ ~i ~ ~
_ `
~
i
~
~
~
~
1 FURTHER CERTIFY that t will register at my local address when the registration books reopen, and
comply with all other requirements ef a legal resident of this State.
I FURTNER CEP.?IFY that [ have no intention to return to my former domicile, and I intend to rcmain in
~ ST. LUCIE , County,
Florida, permancntly. «'`r~ ;
j i--. C'~, a, i
~l~ ~ ~
~ - . ~ ~ 1~ C.
• • ~
SWorn~to and~S~ab~cribcd before me this ~ day of ~
, , .
~ j ~ .
G ,~Gr A.D. l 9.~~
; , Florida :
z
_ROGER POITRAS~CLERI~ C -_IRGUST-~rn~u--~-- ;
f
gy ,~cc,C~.~ ~~1~~ Deputy Clerk 1
~ ~231 ~i359 -
Al;n i . . ' I . '
r,- Y-: - . _ . _ - _
. ~ . _ ~ _ . . _