HomeMy WebLinkAbout0512 ~ . . . . . . 1~ ~
Deciaration of Domicile and C~tizensh~p
TO THE S'fATE AND COUNTY TAX ASSESSOR~
ST. LUCIE CpU~y, FLORIDA: ~~,SS
This is my dcclar~tion of Domicile and Citizenship in the Stata of Florida that I am t3ling this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
t was formerly a legal resident of ~~K~ ~ , N~ and I
_ - (Cih) ^ • (Saa)
resided at ~ . However, I have dianged domicile to
- ~sa..e soa N~me.r) y ,
and am and have been a bona ~de resident. of the State of Florida since day of
`'L ~ , 19~ and I reside at c~ ~ I ~ ~ 1 ~I~R/~ ~ • ~q~
, (SWet aad NwaMr)
POR~ S~•~11G , St . Lucie County, Florida,
. (atr) -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Florida.
, (ta~srt Aae aar pertiaent tacts. such as aale o[ pwpettr or businas, or relinqubhmsnt ot aaplormsat at fam~c
doafc~e, temorsl ot tsoulr to aew domicite. purchase ot haae, etc.) ~
ENTERING CNILDREN IN SCHOOL~: HOI~:STEAD EXEMPTION; ~
if entering children in school, ~ .
please l,ist their names: ~
fu~a ~MO~co~~ ~ ~
- sT. ~uc~ wTr
aocf~ Pom~~s
~ CIEiiK CIRCUtt COURT -
RfCORQ YER'FIEa -
~tT Z~ 1~ 28 pM1'7~1
~ 294158 -
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I FURTHER CERTIFY that I wiil 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
S~~J(~ ~ ST. LUCIE . , County,
Flocida, permanently. ~ci~r) .
,
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j ~hed before me this ~ day of
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' ~ g ' ~ 74 ~ ;
°
. `l:~ A.D. 19 ~o
J:.~::~: . ~ r. a'.`~« '
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= v,~pJ~E~~ PO ~ C RK CIRCUIT COURT ~ Flarida
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'~~f,~ De puty C 1 e rk w. 3 J
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~ `(To executed in d~plicste ~od oti~inai fied with Cktk Circuit Coutt. ~nd duplicale with Tu Asseswr)
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