HomeMy WebLinkAbout2411 ' f Domicile and Citizenshi ~
Declarat~on o p
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TO THE STATE AND COUNTY TAX ASSESSOR, ~ ~
ST. LUCIE CpV~y~ FLORtDA: . ~~9~O
This is my declaration of Domicile and C'itizenship in the State of Florida that I am filing this day Pn
accordance, and in conformity with Section 222.17, Florida Statutes. ~
I was formerly a legal resident of $rOom c~ ! I , e hr~a and i'-~
tcur)
resided at ~ Wr5 ~ . Howe.wer, 1 have changed my domicile to
i~ • ~sa?..~..a N~ea) -
and am and have been a bona fide resident of the State of Florida sina day of j
.
, 19~_. and I reside at ...3./ ~~o r¢ S~~ _ i- i V~ ;
/ t (str..i ..e Hr.ar)
' 1"o r`~ s~ ~C.. ~/c i e~ , St . Lucie County, Florida, ~
(ee~eey) - ~ i
and this statement is to be taken as ~my declaration of citizenship, actuat legal residence and domicile in the State s
of Florida. `
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(Imen Aae anr pertiwewt tscts. sucA as sale ot p~opatr or b~siaen. or t~meat of s~plo7~seat ~t tanaa -
danic~e. removai ot famib to ~ew domiale. parcAase ot Mowe. ete.)
ENTERING CHILDREN IN SCHOOL: ~ ~HOMESTEAD EXEMPTION:
If entering children in school, ~
please list their names: ~ ~-~-~re~
t
P~ ah ~
~-t a S e om~
~ ~E' 1~19 Rf CORD~ ~ i
~ ~ wc~ cou~~r F L - ~
RacE~ ~aT~
C~ERK C1RCU~ couaT
_ . , RECO~D ~Eq1f1ED
I~ i~ ~O ls ~M'1~1 -
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; - 29~5i~
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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 legat resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~t"o r`~ s~- ~~tl~ ~ ST. LUCIE , CountY,
Florida, permanently. . "
~
:p~~%~~P~C. .
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~ h e Tz ma-e~? e~2
~ . _ _ IGNATURE
~ ~
Swqt~ ~`o;~~,su ~.#'~fQre me this ~ day of
. .b~":
~ ~~~'f'~~~~ ~~~.j~~G ' A.D. 19 74 ~ /3 ~~ores~ ~r:
' ~ • ~tl • ~ , '-Pf~i13'f~g Aadr
~'i `~pY3 ~.ERK IRCUIT COURT P~~-S'f ~ Floricta
u
`~~'ti ' , , 1~ ` ~ J - . .
S . ~`~er~:.•F. Q+ _ "
- ;w~~,'° v Deputy Clerk _ .
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