HomeMy WebLinkAbout0397 Deciaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, +~i~O,`~
ST. LUCIE ~pU~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 conformity with Section 222.17, Florida Statutes.
1 was formerly a legal r~ident of ~~-p ~ and I
(ct~r) . (saa)
resided at 1~~T~ R~~~~--- . However, 1 have changed my domicile to
~sa«~.aa rr~ma~)
and am and have been a bona fide resident of the State of Florida since da~? of
~ I raide at ~ ~ " `
~ , 19_.~~_, and ~ ~ ~
~ (StrMt a~d Number)
~ 3 35~s 2 St . Lucie County, Florida,
(cattr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Flarida.
(Insert Aae aar Pe~tineni tsct~. sucu a~ saie ot pro~ir or eu~nas. or nt~~~.nmen~ ot emaorn~e.~ ai to~eec
domkie. ~emoval ot htRily to ~evr domkik. purdase ot Aome. ete.)
• HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. .
If entering children in school, ~
please list th r names:
~
~ ° ~
~?Nff itEWR ~ ~
FIlEO
=T~ pOCEq PO
tNAS ~
C~ERK GtaC1! O COUwT
RECORD VER1f1E
- ~0 ~l
E S~t Z3
. 292002 -
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 Coanty,
(cur) - ~
Florida, permanently.
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~d suy~9~d before me this day of , ~ i~
~ =~;r _ . 74 ~G~ ~ ~
~ " . A. D. 19
I rr., ' • I
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RpGL~"~~tiTRAS, CIERK CIRCUIT COURT , Florida
~
~ 1 De ut Clerk
B P Y
~
(To b t~eutsd io duplitsle snd o~inal fdeA witb Cktk Cireuit Court. and duptic~t~ witb Tu Aa~or)
OR .
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