HomeMy WebLinkAbout0420 Declaration of Domicile and Citizenship
~ . 29~1'~
TO THE STATE AND COUNTY TAX ASSESSOR, .
ST. LUCIE CpUNTy, FLORIDA: '
This is my declaration of Domicile and Citiaenship in tht State of Florida that I am tlling this day in
accordance, and in ~onformity with Section 2 2:17, Florida Statutes. ~
1 was focme
ly a legal resid nt of ~`r~ . , ~ ~ and I
sc.a
resided at . However, I have changed my domicile to
tsa«e.pa N~mes.)
an am and have been a bona f de r~sident of the State of Florida since ~ ~ day of
, 19~ and I reside at o ~
. (sa«t . Humb.r)
~ St. Lucie County, Florida,
tc:ur)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(tasert asra aay Partineat hcts, such as sale ot propertr or businas. or rcliaquisbm~nt ot emplormeat at to~ar
domie~le. remoral of familr to new domieile. putchase of Aome. ete.)
. HOMESTEAD EXEMPTION: II
ENTERIN~ CHILDREN IN SCHOOL. ~
If entering children in school,
please list their names: ,~9~
1~
; v .
f~0 ~MD RECOROfp
_ iT. WCIE COi1NTt fLA.
~«X~~ ~CUtt C URt
~+~'CORD YEq~FlED`
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I FURTHER CERTIFY that t will register ai my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FUR ER CE IFY that I have no intention to return to my former domicile, and I intend to remain in
~ - ST. LUCIE
, County,
ccnr~
FipriBa ~(an~,ntly. .
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~ ,J . .f ~ SIGNATURE
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~ Sw~i Cd ~uD~cribed before me this day of
. , _ ~
~ A.D.19 74 '
r
ROGER POITRAS CIERK CIRCUIT COURT Florida
s
- g ~..~~2- ~~Deputy Clerk
Y
(To b~ ~~~cut~d in duplk~te ~nd oritina! fi{ed with Cleik CitcuM Co~t. ~ad duptk~t~ w~ith Tu A~sera)
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