HomeMy WebLinkAbout2842 Deciaration of Damicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
ST. LUCIE . cpV~y, FLORIDA: ° ~~•9
'I~is is my declaration of Dornicile and Citizenship in the State of Florida tt~at 1 am fcling this day in
accordance, and in conformity with Section 222.1 Florida Statutes. _
S/ M PSO N ~ y~N~ s`/~vA~~~ndl
1 was formerly a legal resident of ~~~r~
. However, I have changed my domicile to
resided at .
~ (Strett ~ad Numbet)
and am and have been a bona fide resident of the State of Florida since ~~o v day of
a~ P r» j? , 19?3 y and 1 reside at ~ p yZ ~ r'~ ~ x S T.
(Sqstt awd Nwabr)
Po R t -s l' ~ ~ St . Lucie County, Florida,
(~~r) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lassrt Aere anr pe*tiaent ixts, sucA ss sale ot PmpKt1 of bw+~• °f nwWui~hment ot emplormeut ~t to~me~
domieie. remoral ot fueily to new domicite. Pu~chas~ ot Aome. etcJ
. HOMESTEAD EXEMPTION:
ENTERING CHII.DREN IN SCNOOL.
If entering children in school, 4~~-i _
please list their names:
C AR L H~/~Cf ~RL K I RP•vOVNC p~ ~1 y RPS/ d P~-t y
i,~, rh~ sr.4r e o,= Pf~.~.syi..,4,~..n
Soa. /S e.~-Re//,~cy As - ~4c~,v~ Ovey
pov , r9~3 wti~ ~c o
FRPSr~ ~1fA~ A T '?It ~ g ~
A /a d 7 h f-
vti~ v~.es~Ty oF 6/o.~~v/~. ,~,~ti Thp ~I.t. /~l~~+Y
- FAcT t hAT ~ ~/.4 d F~/~ "~,~~^r~o••~
p.= -t rr ,Ab~is~i i~~ ~/o.ti ~A /4s rhr s
_ ~rr~ J P~, c L s i~ c e P~Rc ~ri9 s~~ y -
ST
lUC1E COUNTY FI.~. '
RocEa Po~tR~s ~ A N o~n c A r ~ P v z- r% r~ ~r rT.
CIERK Ci~CU1T COURT ~ vc i e ~A p'~' 3 JA ~
P,EC~1~u vER1~tE0~ ~OQ T S T.
$Et 11 10 261H'1~1 ~ 9 ~ r N ~ D r~ ~ ~ ~-~,4,• ~
~.t~ T e•c. T ~ o•v o r .fl e T v,e .v ,.t ? T o T h~
_ ~P.cti r y/ vA~ ~ ^ •2~ri~P.~.c r_
~9~5''19
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 I have no intention to return to my former domicile, and I intend to remain in
ST. LUCIE County,
~dRT ST.~vc~~-t ,
Florida, ~~~je~ldY• ccnr~ ~ -
~ ~ ~ ~ r ~r. .
;
'~~~G` :~..C~~`''~y+_,.{ , .
~ ;y-_ , _ c,~ ~ ~ ~ . :
f. • J - ~ Mfs.
w
- ' • .v_x~~~' ; J_' ~ h,v ~aw~ har ~k ~ -
- : .
~ ' ~ n~; - ~f." SIGNATURE
_ `
.•se~ ' `'r 4 ~
-~t'•:~ ~~'+-~';;f: 'r~~~- .
bs~~jpbd before me this I day of
S~~ C
~t _
` A.D. 19
8 r
ROGER POITRAS CIERK C RCUIT COURT , Florida
gq ~ c,~~u., puty Clerk
~
' (To ~ ts ed M drplieste snd orlsiasl tied with Ckrk Circuit CoYrt. ~ad duplic~te witA Tu Awwo~)
d00~~ ' AGO Fnrm ~1 22