HomeMy WebLinkAbout1547 Declaration of Domicile and Citizenship ~ ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~
ST. LUCIE ~pV~y~ FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. -
I was formerly a legal resident of ' ~ . ' ~d I -
r) a)
resided at '~_1C2. ~ . However, I have changed my domicile to
. tse...t wa t+wae~.)
and am and have been a bona ffde r~sident of the State of Florida sincx day of
• ~
.~,1~.~ • , 19
~
~ and I reside at ~ 7_ ~ p^L~~'' a~ ~ . -
~ (Strat se0 NuaDK) -
~ ~ St . Luc ie County, Florida,
(a~r) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(I~art hsn sa7 Pettineat bcts. wch ss sale of propsrtr at business. or telinquisAmeat ot ~mployment st fo~o?er
domicile. removal ot tamilr to aew domicile, purchase_of Aane, stc.)
• I~OMESTEAD EXEMPTION: ~
ENTERING CHILDREN ~N SCHOOL. ~ _
If entering children in school,
please list their names: ~
- .
- f ~~ID itE~
f~l~iCif COtirIT~
' ~IOCER P4~T#~f
~ CLER~( C~~C1lIT L'WR1
- ' RECORO vf4~~lED
Nw ~ li 2~ AN'~~t -
i ~
~
~ 294962 _
~
I 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
~ ST. LUCIE
~ ~n_ , , County,
~
Flon
ad , permanently. ccitr~
. •
~ •
M• .~•'~~.i.i. . . (lA%1/"~~ .
~ ~ : SIGNATURE~~~~b f~
. , .
: ~ .1 '
Sworn'to and subsc~ibied before me this day of
. ~ : , A.D. 19 74 . /J~ ~ .
• . : :r:;; 1~ $ r
RU~ER~ PQITI~A ~LER CIRCUIT COURT ~ ' , Florida
~ ~n';"'r•: . . ~ 33 ~!J v
gy ~ Deputy Clerk .
(To e:a~ted in duplicste aod original filed wilb Cle~k Circuit Court, snd duplieate ~vith Tu Asressor)
.
. 600ic ~e~ PACE ' ~ ~
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; . •ss~Ch ..v n _ _ _ . _ . . . a f`"~~a~~'
. }y,F ..;4 ; T .j; ~'Y'v~~'~-
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