HomeMy WebLinkAbout2893 Declaration of Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR. •
ST. LUCIE CpU~y, FLORIDA: ~3s84
- ,
This is my declaration of Domicile and Citizenship in the State of Florida that ! am filinE this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
I was formeriy a legal resident of ~ ~d ~
(a~r) ' lsu~)
resided at . However, I have dunged my domicile to
csa Nume..) •
and atn and have been a na fide resident of the State of 'da sin ~ _ day of
~ ~ ~
~ , 19~, and I reside at ~
tsu.~..a nw.e.~)
S t. Luc ie County, Florida,
(a~r)
" d this statement is to be taken as my declaration of citizenship, actual k~gal residence and domicile in the State
of Florida. •
(lnsert here any pertiacnt taets, such as sak ot propenr or businas. or n1i~i~hneM oT s~eP~°r~~ ~~O~K
don?icile. removaf ot familr to aew domicile. PurcAase ot home. ete.)
ENTERING CHILDREN IN SCHOOL: ~ _HOMESTEAD EXEMPTION:
If entering children in school,
please list their names:
_ N
f LEO ANO RECOROEp ~4
- i~.lt~C1E COUNTY FIA. `
R4CER POITRAS
- CIERK CIkC@lT COUIIT
RECORO YERtF1E0
- ~ ~Ct 1O ~3 ~M'7~1
2,93684 :
I FURTHER CERTIFY that I wilt register at my lacal address when the r~gistration books reopen, and
' comply with all other requirements of a lega~ 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,
,
Flocida, permanently. cci~r)
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' 'r`~. ~ ~s`.. _ R / i ~ ~ y ~ h VC.. /L / l'~/I'
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Sx~o~ft,p a~ta st~~t~q~~efbre me this ~ day of
~ v, i. ~':~Y c? . . 74 ~
t . A. D. 19 1 1 r s s
~.:~~',.~;`;fc:;` ,
.~I~:`_ . IERK C RCUIT COURT , Florida
~..~lu~~.~ ; ~ ,
. ~--C4
gy Deputy Clerk ~ .
f To etecuted in duplicstt and wi,~ina) filed v~ith Cletk C'vcuil Co+r1. swd duplicsls w~i1~ Tsa A~eca~or)
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