HomeMy WebLinkAbout0062 Deciaration of Domicile and Citizenship ~t '
TO THE STATE AND COUNTY TAX ASSESSOR. ~9~~43
ST. LUCIE COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that l am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
1 was formerly a legal resident of C~~-~ and I
(n~r) ~ (s~ a)
. However, I have changed my domicile to
resided at ~ ,
(Strett sad NumOa)
and am and have been a bana fide resident of the State of Florida since ~ day of
r~.~,~ ~ ~a ~0
, 19_~, and I reside at . 3~ a •
~ , (sa..~ a~a N~me.~)
~A _ St . Lucie County, Florida,
(ci~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(insert hae aay pertinent bcts. su~n as aak ot Pwp«er o~ a K~~~eAC ot anaormea at lormer
• domic~7+, removal of familr to new domicile, purcAase of home. ete.)
• HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names:
. .
~ ~
C' ' ;~a .
_ ` _
~ ~'-~~.i -~~--`~y'-'~
~ i
. -~-E~~~p~ ~
aOCt
~ k L~'
_ REC
A' YEa. fj~p~
-+.,~s
~ ~8 2 ~4 PH'J+1
s -
,
!
~
~ ' - ~~743 ~
~ 1 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
~1_~e T~ , , County,
Florida, permanently. cc~~r~ •
_ , _
~ ~ ~ ~'1
A '
~
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j S ICNA ~ -
~ L~; ~ _
;
~ ,~••;~#.~~•.~,~~'ti.-; r
i • M • ribed before me this day of
, Sry~~t to aitid~,~~.
„
~ : ~£~~t.{~ , _t - A.D. 19 74 ~ ~ i.
. s~ . R, : ~ ; 1~fI3~g r
~ r- ,
~ . ~iGEI;,;.P9~ S', CLERK IRCUIT COURT ~ ~~f- , , o , Florida
~ : ,r~~~ e.~ ~
- ~...•l~~i~~~`~' _ x
' Deputy Clerk . ,
(To b~ t~e t~ in duplk~te uid oti~in~! filed with C1etk Circuit Co~rt. u~d duplkste wit~ Tuc As~e~) 2
;
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