HomeMy WebLinkAbout1563 • i ile and Citizenship F:
Declarat~on of Dom c
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2` ' 96 :
U THE STATE ANU COUN7'Y TAX ASSLSSOR,
ST. LUCIE CUUNT~', FLORIUA:
'ft~is is my d~claratio~~ of Domicifc :~nd Citizenshir in th4 Statc of Florida that I am filing this day in
accordancc, and in conformity wil1~ Scction 222• 17. F~orida Statutcs. . C
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1 was iormerly a icgal resident of
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residcd at `U°'~ ~~-l ~G/e " • However, I have chaq~d my domicile to
~s~~K~ .pa N~~~~~ day of -
and am and havc b~en a bona fide cesident of the State of Florida since
~ , ~ 9 and i reside at -'1~~~`~ ~
(Stt Gd N4mbec)
~ :~l~C!-c
c. , ~ . ~ 1 County, Floridat
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and this statement is to be taken as my declaration of citize~sliip, actuat legal residence and domicit~ in the State
of Florida.
(Inse~1 here anr Pertine~~ (Kts, such as sale of propertr or Dusiness• °r «~~^Vu~ment ot employmrnt st totmet
~ domicile. removal ot tamilr t~ new domicde, pur~hase of home, etc.l '
~ ~
~ *T ILDREN IN SCNOOL: ~ ~iOMESTEAD EXEMPTION: ;
E.3TERI..G CH
If entering children in.school,
please list their names:
~j~~/~it>yy ~ ~/...~.rn.,.~
r SG O :z ~ CL~
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~EC~
f~~1EpN _ _
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~1 t~ ~ Ai!'r~!
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I FURTHER CERTIFY that [ will register at my local address when the registration books reopen, and
comply with all other requirernents of a legal resident of this State. _ -
I FURTHER CERTIFY thai ! have no intention to return to mp former domicile, and I intend to remain in
ST. LUCIE , County,
Florida, permanently. «~`r~
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_~g~~i ~~0:~ _
~~r • ` da of
5~~,{ b~~y~~~~~~ore me this Y
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: c~ : f~_ r-_~ 19~~.
o : - A.D.
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. ~ Florida
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By r~
~ Depu~; Clerk
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