HomeMy WebLinkAbout0247 Deciaration of Domicite and Citiienship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~~~~?8
ST. LUCIE CpUNTY, FLORtDA:
'It~is is my declaration . of Domicile and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. -
1 was formerly a legal resident of E N S t' s~d I
- (c~tr) (stsa) ~
resided at q ~ vF- , However, I have changed my domicile to
~ tseie.~ .pa N~me~.)
and am and have been a bona fide resident of the State of Florida since day of
Su L~_- , 19..~.~$E.~ and I reside at ~2~~.~b~-~-T~ `L Y~=
~(Swtt asA Numbet)
~ p St . Lucie County, Florida,
(Cier)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(inssrt Aen sar pettinent hcts. such as s~le ot prop~rtr o~ business. w reNaqunhment of empioyn?ent at formet
domkle. tea+oval ot hmilr to aew domie7e. Purdu~e of Aome. etc.) ~ ~
ENTERING CHILDREN IN SCHOOL: HOMESTEAD EXEMPTION:
If enterin cliildren in school,~ .
please list their names:
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P,~~-~l c',~ :.___r.3~r~c.LY___.___ .
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cc~~ Fo~r~t~s t
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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
~ ~a ~ / - _ - ST . LUCIE , County,
Florida~;~nently. ~
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'g ;§u • v ' . before me this ~ ~ day of
,r~f~ t~',., ~
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= A.D. 19 74 7"~ 0 1-. !~-t r~c.~ 1~ vl~
g aaress
- ROGERt POITRAS ~ CIERK CIRCUIT COURT n , Florida
. j~-,
,a gy Deputy Clerk
a~
` (To b..sseu~sd in d~plica~e .ad o~iaal fikd wi~h C1erk Circurt Cowe. ~nd duplicate witk Tu Asfeawt)
s ~ e~ 2~i2 ~47
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