HomeMy WebLinkAbout1534 Declaration of Domicile and Citizenship
TO THE ~TATE AND COUNTY TAX ASSESSOR,
ST. LUCIE Cp~J~y~ FLORIDA: _ .
'Rtis is my ~declaration of Domicile and Citizenship in thc Statc of Florida that 1 am t~ling this day in ~
accordance, and in conformity with Sectiort 222.17, Florida Statutes. -
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1 was formerly a legal resident of ~'11A'~~ , ~~R ~a`'+ and I
ta~r) ts~)
resided at ; q
7~~ N W /3 A+~ . However, I have changed my domicile to
(Strat ~nd N~a~~) ~
a~d am and have been a bona tide t~sident of the State of Florida since day of
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s-Q-, and I r~side at ~ 6 b/ So ~~',N /.~1~.~/ l~i~ I.k~ a~r'
~ ~ (sen.~..a Hw.e.~)
~t.,~ ~ ~ St . Lucie County, Floridar
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and this statement is to be taken as my declaration of citizenship, actual legal residence and dotnicile in the Stat~, ~
of Florida.
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(tnan a.~e anr ~r~;nen~ tsca. wce as sa~e ot Pro~~ o. eu~oe~, o~ re~Qu~sem.ne ot anaormsec a: t«mer
domie~e, remwral ot familr to aew domicile. purchase ot boeae. ete.) ~ t
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ENTERING- CHILDREN IN -SCHOOL: ~ HOMESTEAD EXEMPTION: ,'r
If entering children in school, -
please list their names:
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, ahd
comply with all other requirements of a le~at resident of this State. . ~
I FURTHER CERT[FY that I have no intention to return to my former do ''le, and I intend to remain in
~ ' ST . LUC unty,
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Florida, permanently. tcicr~ ~
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. t ~ FiE'Qi?'/l S IGNATURE
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' : . , - , , . ~ . Q day oF
-Sworn to:a~rd sliti ~~before me this • ,
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, . ~ 74 a/ S ~vd~ iv~
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_ ~ A. D. 19 _l~'~'~~Cd'c~r~~"_'
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~ROGL'~R.~~~RAS CLE CIRCUIT COURT ~ , Florida
g Deputy Clerk ~
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(To e:tcuted ia dupiicate and aifinal filed with Ckrk Circuit Corrt, aad duplicate with T~: Asseaw)
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