HomeMy WebLinkAbout0386 ~ Deciaration of Domic~le and Gitizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 291994
ST. LUCIE CpV~y~ FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am ~ling this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ,
1 was formerly a legal resident of , P r ~ and I
(ci~r) (se.~.)
resided at ~f X ~D A . However, I have changed my domicile to
-csu..~.~a N~mee.)
and am and have been a bona fide resident of the State of Ftorida since day of
e _ , 19~___, and I reside at ~ ~ a ~ . `3 3 ~ .
. (ser..~.sa H~ma~). .
~ e r C e, S t. Luc ie County, Florida,
(ct~r1
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(~iasn nete anr w*cinept tsets. sacn as sale ot propertr or eusjnas. or tcuapuanmene or emplormeoc ac tormet
domiciN. remord of tsa~ily to new domieik. Pu*cbss~ ot home. etc.) .
~ • • HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ _
If entering children in school, 4~=1
please list their names:
onv? A~~~ ~
e
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LJ , I ~ ~a m~~ ~-e ~~o ~.S R~ RECOR~ VE~~F~EO.....,~~
SEr 13 9 i6 ~!!'7~!
, 291s94
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I FURTHER CERTIFY that 1 will cegister at my tocal address when t~e registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domicile, and I intend to remain in
7-~ ,P/ e ~ ST . LUCIE , County,
r~
Florida, permanently. «"r~ •
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~ , - ~ ~i~~' . . o~~'~ S IGNATURE .
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~ •m td and ~~~`t~~~1~~'°' before me this day of
• _ n
~ i = A.D. 19 74 aO a J~3i~` ,
if . . . ~ :
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~ 1t0~ 'S CIERK CIRCUIT COURT , Florida
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~ g ..,,1 ' J Deputy Clerk
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~ (To b~ ~z sd in duplicNe u~d oti~inai flkd with Cls~k CiteuN Cowt. and duplicat~ with Tu~ A~eawr)
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