HomeMy WebLinkAbout2758 Declaration of Dom~cile and Gitizensh~p
TO THE STATE AND COUNTY TAX ASSESSOR, ~+`~~a~,'~r3
ST. LUCIE cpV~y, FLORIDA: .
This is my declaration of Domicile and Citizenship in th~ State of Fiorida that I am tilin8 this dsY in
accordance, and in conformity wi~h Section 222.17, Florida Statutes. f ~ ~
_ ~ , = and I
1 was formeriy a legal r~sident of P--~ I t h ,
~ cpa~ csa~.) .
. However, I have chsngcd my domic:te to
resided at '
( a~d Nwnea)
and am and have been a bona fide r_~sident of the State of Florida sin~x f~ day of
e 19~ and I reside at ~ n~
I D t.~ ~ t'~ r - 7~ D ~
-.--r- . ~sa..~.¦e r~.e.~)
S t"e ev, ; 'e r St . Luc ie ~ County, Florida;
tc~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(I~sert ~~e snr Pettinaat f~cts. sud~ as saN ot Otopertr w~. a n~W~msat oi aspbratsat ~t tonser
domiei~, removal o~ (aaulr to aew do~nic~7e. PuceDa~ ot Aome. ete.)
. HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ _
If entering children in school,
please list their names: 29~523
o m a s 1- ~°uciE ~
~EoofR vo~nu
RECORO YfRIfiEO C~
- ~ 1~ i ls PN'?~l
j ' :
1 FURTHER CERTIFY that 1 wiU register at my local address when the registration books reopen, and
comply with a!l other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have nv intention to return to my former domicile, and I intend to remain in
• erc~ ST. LUCIE County,
,
Florida, permanendy. ccnr)
. !'.c~1ucJ-'-
$ ICNATUI~E
n .
Sworn to and subscribed before me this day of (S~~ ~ .
~ 77 ~ ~
A.D.19 74 ~ `S.
ItOGER ITRAS CIERK CIRCUIT COURT , Florida
g ~-c.l~Deputy Clerk
~I L
(To b~ t:ecrud i~ duplic~t~ wd aiti~al fied witb (~t Circwit Corrt. ~wd dYPticat~ aicM T~ AsMawr)
. . ~ R PAG~~I~~ • '
~ ~ 600K .
~ ACO For,n ~t-~2
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