HomeMy WebLinkAbout1566 I ration of Qornicii~ and Citizer~s~ip
Dec a , ~
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1'O THF STATE ANU COUNTY TAX ASSI.SSOR, yt ;
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ST. LUCIE CpUNTY, FLORIUA: ~
This is my dcclaration of Domic:lc and Citizcnship in thc State of Florida that 1 am filing this day in
accordance. and in confonnity with Section 222.17, Florida Statutcs.
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' - ~ ..~1o a and 1
1 was formerly a Iegal resident af ~~~Y~ ~ ~y~.,~~
~ . However, 1 have changed my domicile to
residcd at l'~ S ~
($treet sod Number)
Q'-~ d~l Ot
and am and have been a bona fide resid~nt o[ the State_ of Florida since
oll.~ , 19~ and 1 reside at ' ~ ~
( eet a~a i~lumber)
~ ~ . ,,,~f: . ~ ~ County, Florida,
~
(Cti~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence ar_d doinicile in the State
06 Florida.
(lnser~ kere anr pertiaent facts, such u sale ot ptoperty o~ business, ot rolinquishment ot emplorment at totme[ j
domicie. ~emoral ot tamilr to new domicJe, purchase ot home, etc.)
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E'vTERI*?G CHILDREN IN SCHOOL: ~ NOMESTEAD EXCMPTION: ~
If entering children in school,
please list their names: ,
.
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29~69f3
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I Fi1RTHER CERTIFY that I will reg,ister at my local address when the registration books reopen, and
c~mply with all other requirements of a legal resident of this State.
I FURTHER ~E TIFY that 1 have no intention to return to m~ former domicile, and I intend to remain in
J ST. LUCIE , County,
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Fiorida, permanentl ~~``y~ ~
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;,~,._>J:. _ _ _ FL~ck -
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Sworri tQ• :_~sub 'b~f before me this day of
^ ~ ~ _ ~ .~J
A. D. 19~~ - _
~ , Florida
ROGER
gy a~~ Deputy Clerk
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