HomeMy WebLinkAbout2262 ~~ciaration of Domicile and Citi~enship ~ ~
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE CpUNTY, Fl.OR1DA:
This is my decla~ation of Domicilc and Cjtizenship in the State of Florida that 1 am filing-thts day ~n
accordance, and in conCormity with Scction 222.17~ Florida Statutes.
1 was formerly a legal resident of ~ S s~ and I
(Cih) ~ (Staa) .
s~ o ~ . However, 1 have changed my domicile to
resided at ~v
(Str~st aad NuiaAK)
and am and have been a bona fide resident of the State of Florida since day of
ND ~1 e m h~~' 19_~2_, and I reside at ~ 9 O ~ Cab r O ~ d~ -
aad NumOer)
i~! . St. Lucie County, Florida,
cur)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. '
(Insert pere snr pertinent fscts. sucA as ssJe of ptope~tr or businest. or rdin9uishment of emFlorment at tormer
daek8e. remord of tsmify to naw domicile. P~rchase ot home, etc.) . -
~ • HOMEST'EAD EXEMPTION:
ENTERING CHILDREN IN SCHOOL. _
If entering children in school,
please list their names: .
An ~r c? ~~.5~ r D~~ I1 -
~o-
F tE0 ,~Np
. S~ tUCIF CO~NT~
F~
- ~lERICC~R POltlb~s -
• RECORG vERI
F~i
f0 ~QtIRT -
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~l ig 9 so ~y ~
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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. _
1 FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
,Q r„~ ~ u L~~ ST. LUCIE County,
~ '
Florida, permanently. - cciir)
.
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',~~~a~i~~~rs~j'- :Y-i '
•:r~.~-' . - SIGNATURE
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:..ti.' Z . ~ r ~
gW;,,,~ ~':t sp~ritfed _before me this day of
._o~tt
~ - A.D. 19 74 ~g
~i~~~r s ~ a ~ ~
j ~ ~ = = f~ .L„ ~q~ Florida
, " " ~ CIERK CIRCUIT COURT
. ti~.,,ft~ :.N~,~~;:_ _
':~•r:r~~
g ~ ~ ~ Deputy Cle rk , .
(To ezecuted in dupiicate ~nd wiRinsl filed with l.'Ietk Circuit Court. ~nd dupikste vrith Tu Asfeawr)
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