HomeMy WebLinkAbout2582 . - ~r
Dectaration of Donnicile an~ Citizen5hip
~9~~12
TO TNI: STAT~ ANU COUN'TY TAX ASSESSOR.
~
ST. LUCIE CpUNTy, FLORIDA:
~
`This is my dcclaration ot Domiciic aRd Citizcnship in the Statc of Florida that~ 1 am filing this day in
- , ~
accordance, and in conformity with Scction 222.17, Florida Statutes.
~ o~C rrc. ~....c~~~ , ~ .~c~ and 1
! was formerly a legal resident of ~ ~
m ~ o, .t.~ Qag~ . However, 1 have changed my domicile to
resided at
..-~.M (Sir«~,aa Numee.)
and am and have been a bona fide resident of the State of Florida since day of
, 19~ and 1 reside at ~ -
~ ~ ;sa~~ .oa r~~+e«)
("'`~~`J ' ~u~ ~~s , - County, ~lorida,
~~J ~ .
(C1tr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. _
;
. ?
~(I~ert here snr pe~tiaeot facts. sucA as sak of ptopettr or business. ot telinquishmtat ot emplormtut at fotawt
domie~7e. remo~al ot tamily to ~evr domicile. PurcAase ot Aome. etc.)
• HOMESTEAD EXCMPTION: ~
Et1TERI*IG CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names: ~
C...~r o=~~~.~-
~ ~~9 . _ .
C Rk CIRCro~p:j~~T L
RECO~D tIERiF1~p ~
i
- 3~r ~3 9 ~o a!'~~
~
. ~9_1_412
I FURTHER CERTIFY that I wiq 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 1 have no intentian to return to my former domicile, and I intend to remain in
' ST. LUCIE , County,
-
Florida, permanently. (~"r) -
~
~ Fea~~R~.~
: - Caa,s~ .~e -
{r'. .
Y~V~ •
'~,~~1~~I~T~~I • ~
~ ~ ~ i~•"K:
J before me this ~ day of
. $~~rRtoen~.S~~rih~
- ~ A.D. 19 74 - -
~ ''L ~ J .i G~?~ ~ , Florida
~
F _ _
~ <<t
. Deputy Clerk ~
- ~y;.. .
- 0 R
~ ' aooK ~f
~ f~GCI T~~~rn; ' I .
- - - - ~
1~ .
~
ti.a~ ~
~ _ . . v
- : .