HomeMy WebLinkAbout0498 . . • • • .
Declaration of Qom~c~le and C~t~zensh~p _
TO THE STATE ANU COUNTY TAX ASSESSOR, "
ST. LUCIE CpU~y, FLORtDA:
'I1~is is my declarutioo of Domicile and Citizcnship in the Statc of Florida that I am filing this day in
accorciance, and in conib~~iiy W~th Sc~tion ~~~:t?, Fit~rit~~ St~te~t~:
1 was formerly a legal resident of ~ ~d I
(citr) (s~'t')
resided at - j~'-1 . However, I have changed my domicile to
. (Stt~+t aoA NumMt) -
and am and have been a bona fi~e resident of the State- of Florida since ~st day of
, 19 ~y ~and I reside at I~3 S~ ~ u G~Po ~iP. .
-"~T' , ~ esa.e~.~w H~a~eer)
_ ~p ~ ~ _ St . Lucie County, Fiorida,
tc~er) .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State.
of Florida.
(Iroerl Aae snr pertinent tscts. such ss sale ot propertY or Ausiness. or ~elinQuishma~t ot emploYmeat at to~ma_r
sse
• daokHe. removal of tsmily w new daakile. PurcAss~ ot home. etc.)
ENTERING CHILDRE;~T IN SCNOOL: _ HOMESTEAD EXEI~TION:
If enteri children in school, ~
please list their names:
, _ _
. s 1,~,~/d e~ ~ _ -
-
9~,~ ~t,~
~ - _ ~
F i~o ~n~~ sEC o ~ ~
a~. ~uc~~ couN ~u.
RDfrfR POtTRAS
- ~ ClERK Ctr[Ctl1T COiJRT
piC+lP:r YERi~iEO
- OEC 1 8 S3 ~1'~~I
~ - ~ ,
~343
I FURTHER CERTIFY that I wili register at my.local address when the registration books reopen, and
~ comply with ap 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, ~
~ri.~ , '
Florida, permanently. ' ~~j~y~
• r"~eQC ~.-a~
L_.~
~ SIGNATURE
_ .
Swocn.fo ~ su~scribed before me this day of
. ...,1t1i~...,
IT~- A.D. 19 74 Sc.! ~ cc ~ Q~~ _
^ ~ ~fli'fig
A8' r -
: 9 . ~ s~ ' ~'•.'p ~i .
_ ~p~ , GI:~RK CIRCUIT COURT ,l~.~i, Florida
• : : : ~ii;~;~t •~'1 nit ' .
zN ~ {3: E .
. _ . ,
' Deputy Clerk
~ - • ~ ~ • ~
~
^!.'~~i ~ ' r~~ ~ t.. ; . '
. ~,'~G E'~C- •~Tie~ uted in dupiicNe ~nd otiiirtal tiicd with Clerk Citcuit Cou~t. snd duplicite with Tu Asses~ot)
'r~/!?~ln~~~~~~`'
' i j~ ~{KJ{?~ ~
~ Af, , i ,
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`~"~~`'~~~~a~i ` - - . . _ .