HomeMy WebLinkAbout2011 Declaration of Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE CpUNTY, FLORIDA: ~~45
This is my declaration of Domicile and Citizenship in the Statc of Florida that 1 am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. . .
[ was formerly a legal resident of f1 ~2- ~-L 4~nd I
(C~tr) ~ (Sae•)
resided at r~ `~~~'G~" . However, I have changed my domicile to
• ~su..~ .~a N~~eK)
and am and have been a bona ~fide resident of the State of Florida since day of
t'-~~-~~ , 19~and i reside at ~
,
. ~ (Stntt aad Nu~abet) ;
~1-~~ ~ . ~~t~~ , St . Lucie County, Florida,
(C+~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insert he~e any pertinent facts, such as ssk ot propenr or business. o~ ~elinQuishmeot ot emplorment st tormer
domicile, temoval ot tsmilY to aew domicile. purchase ot home. ete.)
• HOMESTEAD EXEMPTION:
ENTERING CHILDREN IN SCHOOL. ~ .
If entering children in school, -
please.list their names:
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~or~~t~ ~
C~fRIC CtiiCUIT C
RECr.~n ;~,,r~ED.. ~
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~ ~~45
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1 FLJRTIdER 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
L ~ ~ ST . LUCIE , County,
Flor~~.;~ermanently. t~~~r)
,
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v , _ S I ATURE ~
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~ 5wo;~rt~o ~tbscribed before me this ~ day of
~ ~ ~r 74
~ . 7'- , A.D. 19 ~ ~2~~"Lrj-G-~~7~_-~~
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ROGER POITRAS, CLE K CIRCUIT COURT `y~ ~lorida
~ gy , Deputy Clerk ~ .
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(To be sxecuted in duplicate and oriEinal fYed wilh (:ktk Citcuit Court, ~nd duplkste with Tsa Asuasot)
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