HomeMy WebLinkAbout2529 Declaration of Domicile and Citiiensi~ip 1~ ~
TO TH~ STAT6 AND COUNTY TAX ASSESSOR, ~~~2
ST. LUCIE CpiJ~Y, FLORIDA:
This is my declaration of Domici(e and Citizenship in the State of Florida that 1 am fding this day in
accordance, and in conformity with Section 222.17, Ftorida Statutes. ~
1 was formerly a legal resident of ~d I
' (saa)
(a~r)
resided at ~ ~ X~~ 7" . However, I have changed my domicile to
(sw.~ .pa No~a.)
and atn and have been a bona fide resident of the State of Florida since 9 day . of
~or
6~-~~' , 19Z'~, and I reside at Z~%?% v~~'~ 6'~ o o,S a v r~ ?~~y
, (su..c.pa N~~e.~)
~1-- ~p~.~R ~ St. Lucie County, Florida,
(Cicr) •
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. . -
(lt~sett pere any pertinent fxb. such as sale ot propertr o~ businas. or rNin4~~?~~At ot amplormsat st former
domie8e. removal ot taatiir to aew danicile, PuM~ase of Aome. ete.)
~ . ~ HOMESTEAD EXEMPTIO :
ENTERING CNILDREN~IN SCHOOL. ~ .
If entering children in school,
please list their names: ~
f~ ~`.~/~/t/ /i~ /
Ci o n/ ~ k ~i'~ c° / D_ ~ _
~f1 ~i~ ~ s ~ ~ ~ iv e~ 1 ~0 ~`~u~a"~ c~~1 r~.
OCEA POtT813
CIERK CIRCUiT $4rRT
RECORO VERIFIEO
~ ~i ~'Z~
i - 293432
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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 lega! resident of this State: ~
I FURTHER CERTIFY that I have no intention tc? return to my fotmer domicile, and I intend to remain in
~ ~ ~ ~ k _ ST . LUCIE , County,
Flq~i a'~Liri~tieJit~~ ~ (Ci~r)
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, } i~. ~ : S IGNATURE
~~,~~•:i:~~:,,~
,
Swo~n3o ~f ~cribed before me this - day of
,
~ .
A.D.~19 74 g r s
ROGER POITRAS, C RK CIRCUIT COURT , Florida
gy Deputy Clerk _ . '
be e:ecuted in dup{ic~te and oti~insl filed with Cletk Circuit Court. and duplicatt witA Tax As~)
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