HomeMy WebLinkAbout1807 . ~ . . : . ~ ~ i
De~cl~aration of Dom~cile and Cit~iensh~p ;
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIB ~pV~y, FLORIDA: _
'[his ia my declaration of Domicile and Citiz~nship in the State of Florida that 1 am filing .this day in
accordsna, and in oonformity with Section 222. ! 7, Florida Statutes.
~ I was fonaedy a tegal resident of L~ , ~ ~ 0 and I ~
~ ccuy) tsiw.) ,
resided at ~ov~~ ~ ~o~rr[l D . However, I have dianged my domicite to
~sa..~ ..a rw~e.r~ - - ~
and am and have been a bona fide resident of the State of Floiida aincx day of
~t~- , 19~~` and I reside at
~-~r
i.dr ~su..:..a H...e.~) ~
.
J,,~~ ' St. Lucie County, Florida, ~
Tcicr) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida ~ ~
- a
~ pmen aen awr verwNne tscts. wcb a~ salt ot ptopttr or busin.ts. or nlawui~se~e ot a:p~orme~e u t«aar [
• dowieW, ~c+ooral ot faa~ilr to aew domieiN. PweYa~s ot I~oas~. etc.) ~
t
ENTERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION:
If ente=ing children in school, . {
please list their names: . - ;
•
. ~F'1//N /~.~'E~ _
~
i~i.~°ci~ °eo~wm~~ .
aoc~a ~ome~s ~ .
~ ~ CLERK CiRCU1T COItRT ~
RECOAp YERlFIEO.~.....,,~
. ~ ~1or 11 4 a~ PN'T~I
, . _
f - . ~~1~
I FURTHER CERTIFY that ! wiU 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;',~ • ST. LUCIE , County,
a
FIOnd3,. jf~,~, ri~~i s~:~ ( ~Y) • .
• -
. _ _
. u, >~~j~r~~ ~
? ~ • ~ _ ~ ',i~~pi'~~'~._~ ~ .
1 4+
G ~ t j i'~ ~i!y~~1 .
~sr~,~~~3
~
. ~ . :
i .•~,;~s' " lRti~s_.:t
1, i • . .a~tM .~.~*nr
- i' t~,.ty; '~r .~ti.~.: .S ICi~ i V iV.'.
r i~{'i ~ ~ r 'i' ; _ .
`.~~j~~'s:*~ ~ ~ ~ .
I,~'e
Sworn to"2n~su~~i~ed before me this ~'2" day of 1
-
`~/'?J - , A.D. 19 ~
ROGER POITRAS, CLE:'•K ~IRCUIT COURT ' , Florida
~ f~c,c/ Deputy Clerk .
By t~
(To :~ert~0 M dLpNeat~ ~ad o~i~s~ filed witM C1e~k Circdt Cortt. a~d dnVikat~ ~ritU Ta~ AfMt~ot)
60QK ~.~le~ PAGE ~~nJsJ -
AGO Fr,rr 71.??
~ <r.~-~""''~,~~ ,x ~,s r . _ . - -
~ ~ .s,~'~s.~^~..,,,g a ~ ~,s ~ _ -
- _ _ _ • _