HomeMy WebLinkAbout2636 ' Domicile and Citizenship ~
Declaration of ;
~
~ ~ ~
TO THE STATE AND COUNTY TAX ASSESSOR.
ST. LUCIE CpU~y, FLORIDA: '
This is my declaration of Domicilc and Citizenship in tho Statc of Florida that I am filing this daY u?
accordance, and in conformity with Section 222.17, Florida Statutes.
.C / MA ~ i`'`' ° and 1
I w~s formerly a legal resident of ~«tr~ ~
0
0,2 ,E',,s r~~//~g~'A ~ ST.t«T . However, I have changc~my domicile to
resided at
~ (saat .na N~mde.)
and am and have been a bona fide resident of the State of Florida since ~ day of ~
~ 19-y 0 9 7 s'. •E, •f~~.vo vs.a~ O•e i v t
/9v d ~s s' 7~ and 1 reside at ~~c
~
~Om,~ s r. .t c. t? ~ S t. Luc ie County, Florida,
(Cit7)
and this sfatement is to be taken as my declaration of citizenship, actuallegal residence and domicile in the State
of Florida.
(tnasn he.e anr pettinene taets.:ueh as sale ot aropNtr « b~n~. « tNinqubhm.nt of .mptormewc st tamer -
domlc~s. ~ea~oval ot tudir to new domicile. Pu~hase ot 6oaa~, etc.)
HOI~STEAD .~XEMPTION: ~
ENTERING CHILDREN IN SCNOOL: ~ .
If entering children in school,
please list their names: .,Z ,9i., Pa•~ c~`'''''`~'" c,••~~r•'F
A~ Ad O c.~ F /9 D~/` F.S`S .
il~EO ~ND RE~ORI}~4
iT.ltiCiE COU TY w~. 1~
ROCER P0ITRAS (
C~ERK CIRCUtT COURT
~ RECORO VERIFtEO
~
i ` ~Ct~ 15 I 3S PM'~~i
~
~
~ 293484
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with al1 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
~s ~r s; . .C ~ ~ ~ F ST . LUCIE . County,
,
Florida, permanently. cci~r)
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. : ' _ ~ S IGNATURE
R ' .~'to'~~nd su,,~~,~f , ~ '3~efore me this ~
`~L~day of
r~~_ 74 0 9 7 s.+F• sF.~.~e.•:~ o.~. ~.F
= , ;~z _ _ A.D. 19 _ g r
; ~~fi-.,:..:;: :
Rp~~'p~T~A~~, CLERK CIRCUIT COURT p~r_sr .~vc~F , Florida
gy ~ . Dpputy Clerk , :
(To M uted in dupika~e a~d wiiiosl fited with Clerk Circuit Court, ind duplicate wltA Tu~ Asxtsot)
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