HomeMy WebLinkAbout2105 Declaration of Domicile and Citizenship
. . . ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~
ST. LUCIE CpUNTY, FLORIDA: ~
This is my dcclaration of Domicile and Citizenship in the State of Florida that I am f3ling this day in
accordance, and in canformity with• Section 222.1 Florida Statutes.
I was fornnerly a legal resident of ~~y~~ n~Rk ~R~ . and I ~
( ~r) (saa) ~
r~sided at N V G~1yT .ST . However, I have changed my domicile to :
' (SUsst u~d Numee~) ~
and am and have been a bona fide resident of the State of Florida since ~ day of ~
s SF~TE~?8FR , 19~ and I reside at 1/ EIV C/A y'~ _ ~
~ j (SKatt and Numbet)
~T S~?+ y C!~C' .,~a f St . Luc fe County, Florida,
(ci~r) ~
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State ~
of Florida.
(Insert Aere anr penineet fscts. sucA ss sale ot propertr or businas. or relinqu~limen~'af employmeat ~t former
domic~7c. removal ot family to new domicile. purcAase ot home. ete.) `
L• HOMESTEAD EXEMPTION:
ENTERING CHILDREN IN SCH00 . ~ .
If entering children in school,
please list their names: - ~3~.~
iT. LI~iCfE COUMTY fLA-
IIOCER POITRAf
CIERK C18CU1? COURT
aECaao vEaiFiED.~-~
- Oct 1 12 ~ PN'~
Q~z.~-~a .
, -
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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 domicite, and I intend to remain in
,pQ R 7,,• 5 ~ v G I~ ST . LUCIE , County,
~ (c~~y)
Flarida; ~r~anently.
, , .
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~~~S,~irdr~i~~Q arO~ubscribed before me this ' o day of
~ ' y ~4 y,q ~,Fr?c~•~ c~~v~~
A.D. ~9 a
g r
ROGER POITRAS, CIERK CIRCUIT COURT po~• S_C , Florida
~D ~ 3 3~~
B %~jaL~~c.G (O~ ~Puty Clerk . ~
Y
(To be e:ecuted in duplicate ~nd oti~inal tdrd with (.'lerk Circuit Court, snd du~te with Tu Asseswr)
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