HomeMy WebLinkAbout1533 Deciaration of Damicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 292'737
ST. LUCIE CpU~y, FLORIDA: ~
~'I?~is is my declaration of Domicile a~d Citlzenship in the State of Florida that I am filing this day in ~
accordancc, and in conformity with Section 222. i 7, Florida Statutes. . .
1 was formerly a legat resident of ~.X' r~' ~ r' N~ t~~ f~~ and I
taer) csua)
resided at ~~~~h r ~ r~~~ . However, 1 hava changed my domicile to
-T t a~d Number)
and am and ~ have been a bona fide . resident of the State of Ftorida s3nce S~ day of
~ ~L~
~ ~ ~ , 19_ and I reside at ~ ~ ~
~ ~ /~.21 ~ ~P ~ u~d Nw~b~e)
~
f , a , ~,~U~ St . Lucie County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual lega! residence and domicile in the State
of Florida.
(laMrt Mae aay Dertin~nt tacts. sueA as sale ot p~opaty or busines~. or nKaq~i~ha~eet ot eaploY~newt at lormer
do~uie~, removal ot familr to aew doaicile. Purchap ot hane. eto.)
. HOMESTEAD EXEI~TION: ~
ENTERING CHILDREN IN SCHOOL. ~
If entering children in school, ,2~2~,3~ _
please list their names:
y:%' ,,,f~~- ` ~ -
ri~EO ~~a R+~c
, , ~ RocE ~PO~r~~
I s--: ~ - = ~ ~ . - R CLERR CtRCUlT COU)It
ECORO YERIFIEO~~
o~ t r o~ PM ~r~
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,
~
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I FURTHER CERTIFY that I wil! register at my local address when the registration books reopen, and
comply with all other requirements of a leg,al 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 CountY,
, '
F~orlQ~~~pently. cci ~ •
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~i}¢ ' SIGI~1
.~~:7. ~''•~'snbscribed before me this 2 day of
Svy,~iti tt',o Att ; ; ,
I . _
A.D. 19 74 ~ ,(t ' J! i
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ROGER POITRAS, CIERK CIRCUIT COURT " ~ d,_~L, Florida
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gy~~~-f'- Z~-~-~-~' Deputy Clerk
(To b~ ~a~trNd in duplkat~ ~nd ori{insi filed ~rith Cktk Cinwit Cowt. ~ad duplicate witA T~x Awara~)
• OR ' ~
- aoo~ 2~ rµc
AC~U Fr~rm '1 2?
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