HomeMy WebLinkAbout0127 Deciaration of Domicile and Citiienship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~063 ~
ST. LUCIE ~pUNTY, FLORIDA:
This is my declaration of Domicilc and Citizenship in the State of Florida ~hat I am fiting this day in ~
accordance, and in conformity with Section 222.1?, Ftorida Statutes.
I was formerly a lega! resident of y M U K TN M A S S. ~ /YI A s S._ and i f
{c~tr) tsua) . ~
. .
resided at 4~Q~NS /y/~~- R.a W~'~TE-y~RsE ~A~ . However, t have changed my domicile to s
(Stre~t ~ad Numbet) ~ T.r
and am and have been a bona fide resident of the State of Ftorida. since °?9 day of
OGTd~3F/t , 19.~~, and I r~side at /~ec ~.D~ y ou T' ~~P .cor ao~
~ (Stnst aad Nruabet)
~ St . Lucfe County, Florida,
~
(a~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lnssrt-Aere aor pertlaent hcts. such ss uk of propertr o~ businw. or «Itaqui~hment ot emplora~ent at to~a~r ,
domic~e, tcmw~al ot iamily to aew domicile, purchase ot hoa~s. etc.)
~ • . HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ _ .
If entering children in school,
please list their names:
_ s~uici~ s'~o
~u~mr"~u ~
- aozf~ Po~ans ~
_ c~~uc c~acurr coe~tt
' RFC4R0 YEi3lFtE0
~ ~ ~ - M011.1~ ~0 08 ~'T~
~ _
~ ~ssos3 ~
~
~
~
~
I FURTHER CERTIFY that I wili register at my local address when the registration tfooks 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
~o ^ y O u~ ST . LUCIE , County,
Florida, permanently. tcnr) m a k r i~ G~' ea ~ NF
- r -
'.•`r'4 . . _ , ; _ ~ .
`v„,,{ y~'= .
: • ~
' '•~ji t:7.~r
:
;~~~s~}~; ~ .
` "'~~J •s..• ~ SIGNAI'URE
_
.'S~r. ` ; • '
. . .
. Tx" -
H-r ~-,'~~,~`;u~i
;~efore me this day of
~1I~^~t~ a~`.~~I~tV r ~ : .
:.4~~s~ ; , ; ~
~ 74 0~ . R~>
:~'.f ~ A.D. 19 .
~ : . : . . : , r
. . v. ; _ -
R t;~•CIERK CIRCUIT COURT JENsFN ~oFA~N , Florida
ti-:
" ~
i
gy ` ~ - - Deputy Clerk „ . -
(To be ecrted in duplicate and orisinal filed with Clerk Circuit Court, sod duplicate with Tsx A:ssssor)
- ~oo~ 234 ~eA~ 1~ ~ . -
,
. . _ _ _ .
a~ ~ ~ ~
~
- ~
_ j _ ,a ~ i - - _~3 = _ ~