HomeMy WebLinkAbout0124 ~ • ~
Deciaration of Domicile . and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, , _ .
ST. LUCIE CpUJ~Y, FLORIDA: _ .
Tha is my dcclaration of Domicilc and Citizenship in thc State of Florida that I am filing this day in
accordance. and in conformity with Section 222.17, Florida Statutes. .
. ~C~,,w ci ~ L- and I
1 was formerly a legai residgnt of
(cur) ' tsa~•) -
resided at . However, I havc changed my domicile to
~sa«i aua N~mee~) ~
and am and have beea a bona fide msident of the State of Flodda sintx ~ - daY o~
. ~ F C'~:,Q~l.~~ -
°--vl , 19?
~ and 1 reside at ~ ~
~ , , ts~t«e.na Nwnu.r)
a,,t~ St . Lucie County, orida,
(p~r) ' -
and this statcment is to be taken as m~? declardtion of citizenship, actual legal residence an~ domicile in the State
of Florida.
(laaat Aere aalr pertinent fscts. such ss sak ot pwperir ar eusiness. or teGnquisfuue°R ot eaplolrmeat ~t torn~a
~ domic~le. ~emoval of tamilr io aew domicile, purcha~ ot hom~. ete.)
~ • HOMESTEAD EXEMPTION: .
ENTERING CHILDREN IN SCNOOL. ~ . -
If entering children in school, _ ~
please list their names:- .
a ~
- -
iL~LUCIE CO
EWtiY fu,
aocfA FQit~~s
CIERK CIi:ClIIT COURT ~r `
~ ItECORO YERtlIEO,,,,,~,~~
_ _ . NQlI 26 g 36 ~'l~
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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. ~ -
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
ST. LUCIE ~ County,
. .
Florida, permanently. cci~r) ~
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L
' = ~.~~t_C~L%NF f- ~uiS
~ * _ . SIGNATURE
~.~i~~. ~~uti~~~~. ~,~y ' .
; •
g„y ~ before me this day of
~~V~, j,_ _
U,: ti~~~~~ :F
~ 74
> _ A.D. 19 $
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;R`~~ L~~TRR'~~~= = RK CIRCUIT COURT , Florida
_
: ,I~ j~t gF ,f f : v'~'
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I ~~y 4
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° ~F` Deputy Clerk '
g~ : . •
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'~'8teti~*, '
' ~(~o ee e ~tsd in duplicate ~nd oriRinsl filcd with Clerk Citcuit Courl, ~nd duplicate witA Tan Assessot) -
~0~2~3~ ~ 1~24 } _
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