HomeMy WebLinkAbout2611 Dec~ar~tion of Dorriicile and Citizenship
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TO Tti~ STATE's AND COUNTY TAX ASSE~SOR,
ST. LUCIE _CpUNTY, FLORlDA:
This is my dccla~ation of Domicilc and Citizenship in thc Statc c:' Florida that 1 am fiiing this ~ay in
acconlance, and in conformity with Section 222.1?, Florida Statutes.
~ rn Y e o ~ ~ i c h~ 4 Q n- and 1
I was formerly a legal resident of ~~~y~
q ~ ~Q ~e. . However, ! have changcd my domicile to
residcd at r-~~~ ~
lSueet snd Number)
t1 _ day of
and am and have bccn a bona Gde resident of the State of Ftorida since
, 19~~., and 1 residc at a0 ~ S. -~I~1 O~d
~.R.'~~~--- (susa..a N~me«)
~T ± 5.~, G~ e (~G ~ e. County, Florida,
(nir) ~
and this statement is to be take~ as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insc~t bere anr pertinent tacts. such n sak of pruperty o~ busineu. or relinquishmeat ot emplorment at forma '
domicie, ~emovsl of fsmilr to new domicile, putchase ot home, ete.)
• HOMESTEAD EXEMPTIO:J: a -
ENTERI"IG CHILDREN IN SCNOOL. C~
If entering children in school,
please list their names: -
~nnP 1~9 ~Se ~'S -
CLER~c ~lA'.IpT OO~t
RECOtt9 lK~t~.~.....~
t~ f3 i2 ~c ~!1'~~ ~
~
;
~ -
, _
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 1 have no intention to return to m~ former domicile, and I intend to remain in
• ST. LUCIE , County,
~p~ '~"f t LC ~ L. -
• . (cur)
~ Florida,.Permanendy._ . '
' .t e~;,''•~;~`` . o
. • • ~
, _ _
' ' ' G'~ ~ . ~ .
: _ ~ r~ ~ v~lL-!'-~-~~.1 [ ~ _
. :.~n~. ~A'„y' - - . 1 ~ .
Sworn.4o aii u~caied before me this day of n O~ s~ i dd ~
v~
' ~ A.D. 19~4~. ~
a rt ~ I- t~G + e , Fiorida
ROGER POITRA~-SLFRK CIRCLITT C~URZ__
gy `~~Q ~ ~c ~Deputy Clerk
~ a~K 231 ~~OS . ~
~ /~C:r1 f r,tn' ' 1 2
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