HomeMy WebLinkAbout0530 Deciaration of Domicile and Citizenship
- ~ .
TO TNE STATE ANU COUNTY TAX ASSESSOR.
ST. LtTCIE _ CpU~y, FLORIDA: _ -
This is my declaration of Domicile and Citlzcnship in the State of Florida that I am f~leng this day In
accotdance, and in conformity with Section 222,17, Florida Statutes.
_ I was formerly a legai resident of d~ -~`'~~T~~ , ~ and I
- ca~r) ~ (si.a)
resided at c sl ~ N S d N . Hovraver, I have changed my domicile to
' (Sttatt ~ad Nuiobul
and am and have been a bona fide resident of the State of Florida sincx ` day of
~ ~ ~ , 19~ and I reside at ~ ~a /~i < S7Z=~-t- i .
(sa..t .oa Nw.eu)
?"~O..E'r ~~c Q~,~' , St. Lucie County, Florida,
. ~ (cur) . -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. , - '
' (IroM here anr pertinsot hcts, wd~ ss s~te ot propertr or bu~, or talinq~i~Aaunt ot emptoyuieat at tosm~t
domkiN. temoral of fsaiiir to new domic~e. purchase ot Ao+as. etc.)
ENTEAING CHILDREN IN SCHOOL: ~HOMESTEAD EXEMPTION:
If entering children in school, ~ ~ ~
please list their names: - _ 2941'7~
~Ts.~~ t ~ o ~
~
f~~lElI~CtE CO~UlITY Et,A,
/~,C / C ~fI t~ •L L ~ llOCf A POITRAS
CIERK C+RCUIT COIIOIT
~ RECORO VER~FIEO
/f- /Ciff3~P.~ .~LG , _
~ Ocr 11 !2 z~ P!~'~~I
~
; _
~
~
f - -
, _
I FURTHER CERTIFY that I will register at my.local address when the registration books reop~n, and
comply with all other requirements of a legat resident of this State: . '
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
7~'D ,e7 ~7• ~~F ~ ST. LUCIE , County,
Flanda, pertnanently. ~c~~r~ ~ J
C!/
_ „ . • •
.
..,~t ~;;:~f;:. ~ C ~
`i~~•~,'~~~-ti,~ L1~~.~.r~r~ ~ _ ~ .
• -~1 ' ' ( ~ i _C% ~ :p~ .
~ _ i .G ; =
~ - ~ ~ ' ~ - ~ S IGNATURE
~ ~;~'u.~ Yibed before me this °~4 da of
-.Swotri,~o Y .
.
~ ' : ~ ~.r~v 74 .~2~~~
~ti.~~~.~.
M ~ ~ ~ ~ A.D. 19
8 r
ROGER POITRAS, CLERK CIRCUIT COURT * Florida
' ~ -
- By ~~~-~~C.~i Deputy Clerk . _
M . '
~TO Ot tiKYlfd ~II ilUph~: ~It ~I1d M~[If1iI rlitd Mfllll CICfI[ C+ICYM C01U~. aad duplicste with Tu~ A~es~or)
rI111C ~VV
. ~ . . AGiI t~,~,,,
..ta5" c,~'s °3,ct v.rt~,"~~ `.P .~,.t;.:y . . ..~.r+cv=.--~•-T....~..~.r.f•s-i. _ - -
~b"" r
_
. . . .N.~._ . ~ z . W , .