HomeMy WebLinkAbout0506 Dectaration of vom~ci~e ana c:~t~zensn~p
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE CpU~Y, FLORIDA:
'il?is is my declarotio~ of Domicile and Citizenship in the Statc of Florida that ! am Cling this day in
accocciance, and in conformity with Section 222.17, Florida Statutcs. _ ~
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i was i~c~nerjy a t~~aZ i~iu~ii~ ui . ~a~r) . " -
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resided at ~~L_ S~.11 . . However, 1 have changed my domlcile to
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and am and have been a bona tide reside~t of the State of Ftorida since daY af
, 19~~., and I reside at ~ d a v k ~T .
~ . (Stnet ~xd Numbsr)
~ s~'~_~d ,.,r S ~ . tr ~ , ~ - St . Llicie County, Florida, -
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and this statement is to be taken.as my declaration of citizenship, actual legal residence and domicile in the State _
of Florida. • ~
(I~aett here saY Pe~tiaeat hcis. sucA ss ssk of propertr or Ausjness. Or reliaquishms~t ot emploYmcut at (ormer -
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' QOIUICMO~ (i~t~V~Y v~ ~uw~~ ~v a~.. ..vwwr.s j.~.~..~~ ' . - .
ENTERING CHILDREN IN SCHOOL: :HOMESTEAD EXEMPTION:
If entering children in school,
please list their names: _ .
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. ~ . FIlEO ANC RECORDEO -
~T. ~iict~ ~~ui1~i~ ~L1i.
ROC~P. POITR~S
CIERK Ci :CUlT COURt
RECORO YERlFIE~
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. 296346
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1 FURTHER CERTIFY that I will registcr at my local address when the registration books reopen, and
' comply with aU other~requirements of a legal resident of this State. ~
FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
v c~ ST . LUC IE , County,
Florida, permanently. ~~i"'~
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~Uj1'`.•:K~t-' SI6NATURE
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? 3 _ d s~~.l~gd~before me this day of
=~,r: . 74 ~yo ~S
: ` " A.D. 19
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`t;CLERK CIRCUIT COURT " , Florida
..~I~~f~ •f.. ~ .a(i~te` ~ - .
CO;~- "
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gy . ~ cx.,~ Deputy Clerk
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(To be e: led in dupiicate ~nd ari~in+l tiled with perk Circuit Coutl. and duplicate witA 7~x Assessor)
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