HomeMy WebLinkAbout1533 Declaration of Domicile and Citizenship
TO TNE STATE AND COUNTY TAX ASSESSOR, ~
ST. LUCIE CpU~y~ FLORIDA: ~ ~~9`~1
This is' my declaration of Domicile and Citizenship in tha Statc of Florida that 1 am fliing this day in
accordance, and in oonformity with Section 222.17, Florida Statutea.
: ~
I was formeriy a legal resi~dent of 5~ ?J ~ Ql~ ~d ~T , J~ y 0~~~ and I
(c~er) csua)
r~sidea at ~ LM A~~. N~ . However, I have changed my domicite to_
~ ' ~t Nd Nuwbw)
and am and have been a bona tide resideni of the State of Ftorida sincx ~ day of
,~t fi u~T , 19__L~._, and I reside at ~ c~ ~ t~ r~ u
a R~e - .
/ ' . ~ esb. e eed Nu,ose~)
~e ~C E' - St. Lucie County, Florida,
~ . (~~r) . .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~
(le~ert here anY PertL~ent facts. sueA as sate ot prope~tr businas. ot rsNoQuW~m~nt ot tmplor~a~t at [ormK -
- domicW, remo~l ot famiir to oew domieik. pu~cAase ot oms, etc.)
em
ENTERING CHILDREN IN SCHOOL: _HOMESTEAD EXEMPTION:
If entering children in school, ~ - -
please list their names:
" ~ t1lCIE COti11
1~~~ ~
~ - ROGER POITRAS I,
CLERK CtRCUiT COURT
- R~cOR~ vERrF~Ep
~ ~ e s 4o AM'x~
; _
;
I ~9~1
~ ~ - ~
1 FURTHER CERTIFY that I-will 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-rfi P-r C~P ~ ST. LUCIE , County, ,
Florida, permanently. (~'~r~
!/C~~~ GC _ -
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~ gv ' %~o ~ ` ~ S IGNA1'URE
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~v~~ri-fid~snd s~scr'~l~y~efore me this - O day of
:i: i ~ ~i~ ~ ~ '
~ ~ - :~~c 74
' F ` • /Z/ A.D.19
..C~ ~ ~.'~~4}'',... i _ g
~ re
"'~02 ~ ~ CLERK IRCUIT COURT , Florida
. - .
~ Deputy Clerk ~ ; . ~
(To be e eted in duplic~te aod ori~inal filed with Cktk Circuit Coutt. snd duplicate witA T~t As~e~so~)
e~x 2~33 P~ 15~i - . _
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n.`~,`~`~~~,~ ~.~:~,~~k;~-~-„t 's. '*s~~+~: u-a:' - ~ g~:i ~ti. y^
...2r a :3 ~~2
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