HomeMy WebLinkAbout1972 - N ~
Declaration of Dor~nicile and Cit~z~nship
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COUNTY TAX ASSL:SSOR. 9L~3
1~OTHC STATt AND ~r9Q ,
ST . LUCIE CpU~'Y, ~L,ORIDA: ~
'[l~u is my dccla~ati~n ot Domiciic and Citizcnship in thc State of Florida that ~ t atin filing this day in
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acconiancc, und in conformity with Scction 222.17, Fiorida Statutes. -
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1 was formerly a lebal resident of ' (State)
(c:~r) -
e,;~,,` . However, I have changed my domicile to
rrsidcd at ~g~~K~ ~nd Numbe~l
J ~ day of
and am and have bccn a bona fide resident of the State of Florida since -
~'d6 0 ~
~ ~ ~ , ~ 9~ and 1 reside at - ~ ~~m~)
/ ~ ~ r ~-u c ~ c~ County, Florida,
lCitY) '
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(I~seri hae snr pertine~t ixts. sucA as sak of propertr or business. o~ reli~quishment oi emplorruent st to~mer ;
dwnic~e. ~cmoval ut (amilr to aew dom~cile, purchase of Aome, ete.)
. HOMESTEAD E:CEMPTION: ~
E'.3TERI"?G CHILDREN IN SCHOOL.
If entering children in school,
please list their names:
V /M N v SyeRb~'~ -
290943
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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 CERTIFY that [ have no intenteon to return to my former domicile, and 1 intend to remain in
- e G P ST. LUCIE , County,
(cnr)
rida~_ , anentty.
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_ ..•trely~~ " r .
~:„`_....:C~ s~i~ : , ,
~ +~t~ ~ ~v/ " .
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•~~to ~nd{ C~~V d before me this ~ day of ~ ~
. ~VrociTr ,
:
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• - - A.D. 19~..~
~ Florida
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ROG~~i•p~ITT~ec rT FRK ('TUCr1TT r.ntSttT
gy
~~,_c_d~ C~-~L~-~-~ Deputy Clerk -
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