HomeMy WebLinkAbout2089 Declaratian of Domicile and Citizenship '
TO THE STATE AND COUNTY TAX~SSESSQR, ~s~~r
ST. LUCIE CpV~y~ FLORIDA:
'Il?is is my dcclaration of Domicile and Citizcnship in the State of Florida that I am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~
I was formerly a legal resident of r~~-~ , ~J ~ and I
~ (Cfir) (saa)
~ ~ 5 ln~a~re,f2.e~1 t.Va e~ . How~ver, I have changed my domicile to
resided at ~
~w~~ ($~tNt ~ NY111~f~
and am and have been a bot~a fide resident of the State of Florida since , day of
, 19~~, and I reside at _0~4~.5
~ , . (sa..~:sa N~~,e..)
~C f)~„ L p St . Lucie County, Florida,
7--(cttr) . ' .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~
(lasert hae any pertine~t [acts. suth as sale ot ptope~tY a p~ar. a~~VuisAmeat ot eaiployment at fotmer
domicile, remw~al of f~mily to new domicile. PurcAase ot home. ete.)
~ • ~ HOMESTEAD EXEMPTION: .
ENTERING CHILDREN IN SCHOOL. ~ _
If entering chiidren in school, t?--=1
please list their names:
- - -
s~°uc
~ cou~iTrR~~
CLER~C RCUliT' pUpT -
_ - RF,COAn YERiF1E0,~,~ .
IV~.fS I! zi ~ :j~l -
f .
~
~ - 29~3~~
I ~
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 Count ,
J C ~1 ~~-C12.n~c.P , f Y
Florida, permanently. (citr)
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~ ' ~ • ' I1 iT S_, i ~ ~ ~ ^ T
N ~ p~' ~6(~~'//%
4 /~I /5/ v ~h o ~g 0. k~
~~yvqm~ :,~i~d„~1~ efare me this ~~day of U
; ~ r.r ,
:<G•• . 74
. A.D. 19
~ .
~•A~„ (~~'rRAS LERK CIRCUIT COURT g r S lorida
RO~E , F
g DepuL: Clerk „ . .
(T e e:ecuttd tn duplicate and ruy~.~ 7 fded wi16 Cktk Citcuil Court, snd duplicate with 7ax Assessot)
; ~ BOOK ~~t~7t7 PAGE ~r~0~ , a : , , . . .
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