HomeMy WebLinkAbout1811 aration of Domicile and Gitizenship ~
Decl
'Pp THE STATE AND COUNTY TAX ASSBSSOR. ~ ~
ST. LUCIE ~ ~p~y~ FLORIDA: .
'I'his is my- declacation of Domicile and Citizenship in the State of Florida that I am fifing this dsy in
accordance, and In conforn?ity with Sectio~ 222.17, Flocids Statutes. ,
I was formerly a legal tesident of sc R~ N~ a N - , P~ ww 1 v A N~ A and 1
_ (Cih) _ (Sts~)
residai st Y _ ~ ~ A 4~ : However, I have changed my domiciie to
(SU«t ..a )
and am and have been a bona fide resident of tha State of Florida a~noe dsy of
C'1 ~-~"a !3 ~ R , 19~-.'~._., and I reside stt 4 1/ /1 ~ E .sa ~ ~ a~R C' . ee c ~ e .
~ , csv..t.pe H~e.~) .
s~~~ St . Lucie Cour~ty, Florida,
PoR~ ((~tr) _ ~
and this statement is to be talcen as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~
(la~t Aas ~nr P~rtioeat lacts. wcA ss aN ot pwpa~tr o~ bu~aat. or ~4ai~hmsat ot saplormeat at tona~r
• domki~. tanovsl of tas~ilr to aeM? domkiis. pYrebue ot aome. etc.)
~ . HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ .
If entering children in school, -
please list their names: .
lY) ~ ~ l, ~ 1~ A N,? e ~o w e s~
_ - .
~ AM '~E S
~cIE~04
tR~ 0~
. ' ~°c~a u`t cou~ ~l
~I.~RK ~~~F ED~
ItEC~Ra YE
! ~y 13 8 3s ~'-7`~ ~
;
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E
- 29515~
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
S-~ N c i e ST. LUCIE County,
Y oR~ - '
Florida, permanently. (cic>>
ZU ~ ~o
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. - ~'s. ~ _ SIGNAI'[JRE
• • ~ r'•. C S'~:" . '
.4 . ,.j ~~f''' ,~r, . [J
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~ ~ ' c'~~fore me this day of
<<..
: .3.. ~ : : 74 N E s 6 I ? d A r ~ I .
: • : ~a~~~~" . ~ j A.D. 19. - Y
~i~~-•;-~'-~.'
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• _
CLERK CIRCUIT COURT S f L,,~ c, e, Florida
, _
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,._~~~si~...~t~ti..
g U Deputy Clerk _ „ . •
(To s e:ec~ted ia duplkste ~ed orisiasl fied witl~ Clerk Circuit Coutt. sod duplkate wltb Tu Asa~o~)
60011~ P~~~ - ncn r~.~,,, : - .
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