HomeMy WebLinkAbout2156 ' f Domicite an~ Gitiz~n~hip
Deciarat~an o ~
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"1'O TtIE STATL• ANU C4UNTY TAX ASSI:SSOR. ~~~s
ST. LUCIE CpUNTY, FLORIDA:
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This is my dcclaraiion of Domicilc and Citizcnship in thc Statc of Florida that 1 am Cling this day in
acconlancc, and in conformity wiih Scction 222.17, Florida Statut~~s.
~ / ~ e,ti,e'S /!/iQ/Y/ and 1
I was formerly a Icgal resident of ~,r A~ RD ,
(City) ~ts)
~ ~ c i~ "Ho~ve~, 1 have changed my domicile to ~
rcSidCd at ' ~x , ~
. csaK~.~a N~o~e~, 1 Sf
and am and have bcen a bona fidc residPnt of the State of Florida since day of
~ -
, , 19~! .L-, and 1 reside at ~ ~iQ•e%!/~ 1/E
(screct and Numee~)
~ T ~v~~4- S~ ~l~C/E County, Florida,
(ci~r)
and this statcment is to be takcn as my declaratian of citizenship, actuat legal residence and domicile in the Statc
of Florida. -
(1~~ bKe aor pertinent ixts. sucA ss ssk of propertr ot Mu~eesi, a ttiinquishment ot emploYmeot at tormet -
' domicile. removal of tamilr to aew domici~e. Pu~chase home. ete.) ~
* ILUREt`~ IN SCHOOL: HOMESTEAD EXCMPTI0~1: ~
E?~TERI.IG CH
If entering children in school,
p1eTe list thei names: ~
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~;o- e1/e , ~,A ~vrr~
- fILEO AltD REcOR p
iT. LIICIE COUNTr ~lA. -
ROCER POITRAt i
. CIERK CJRCUIT COURT
RECORD vEariiEO
s~,o ~e ~ ~ ~7~
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I FURTHER CERTIFY that I wip register at my local address when the registration boo&s reopen, and
comply with all other requirements of a legat resident of this State. .
1 FUR'THER CERTIFY that 1 have no i~tention to return to my former domicile, and 1 intend to remain in
~2 v~, / ST. LUCIE , County,
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~lorida, ~ , . (cnr~
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l• ~'~-r~J• ° ~ a~..J~`1~ ~ . ~
~ day of
Sworn ~U~~ ' before me this '
. - . ~9 ~
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~ e/ji e A.0.19~~
' R R O i ~7~ ~L'n/~ . Fiv~3~av2
gy ~ Deputy Clerk •
. sooK~31 ~~2151
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