HomeMy WebLinkAbout0289 Declaration of Domicile and Cit~~enship
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TO THE STATE AND COUNTY TAX ASSESSOR, ~s~.~13
ST. LUCIE CpU~y, FLORIDA: •
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this ~day in
accordance, and in confocmity with Section 222.17, Florida Statutes.
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I was formerly a legal resident of ~~l~t • ~~~a~
tcj~r)
resided at S~~'~L V/~~ ~u ~E . Howevtr, I have changed my domicile to
(Sttstt sad Numbet)
and am and have been a bona fide resident of the State of Florida since ~ day of
J ~~P rn b p/ 19~ and I reside at ~~y~~A
~sa.s~.va N~me.r)
rUl~t !pl ~R~ ~ _ st . Lucie County, Florida,
(c~tr)
and this statement is to be taken as my declaration of citizenships actual legal residence and domicile in the State
of Florida. -
(Inaery he~e anr pertincnt tacts, such u salqpf pwpertr ot susi~s. o~ ~elin9ukl~meat ot emploYiuenf at form~
doaie~e, ree~ora~ ot hmilr to aew domicile. Purcbase ot hoa~c. ete.)
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEI~''~ION:
If entering children in school,
please list their names:
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AbJ ~Eq~
~~9G£R ~ ~
- Ci.EAR CiRUtll~ ~/iMT
' , REC~RO YfR1fIfl..~,~.,`~
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I FiJRTHER 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
D R fi ~~~l~C,~ ST . LUC IE , County,
Florida, pertt~nently. «'`r~ -
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~i~n~c~aqd~u~3~ri,~c1{before me this day of
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- ~ A.D.19 74 r
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~ RpGER`~dl ~~irRAS CLERK IRCUIT COURT , Florida
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gy C, wcc~ Deputy Clerk
(Tp b~ c:~cut~d in duplic~le and ori6insl fi1tA wilA (:lerk Circuit Cou~t. asd duplieate with Tu As~eswr)
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