HomeMy WebLinkAbout0531 Deciaration of Domicile and Citizenship
ATE AND COUNTY TAX ASSESSOR, ~ ~36~
TO THE ST
ST. LUCIE CpUNTY, FLORIDA:
'll?is is my decl~ration ot Domicile and Citlzcnship in the State of Florida that 1 am fcling this day in
accordance, and in conformity with Section 222.17. Florida Statutes.
' ~ ~ _ , ' and 1
1 was formcrly a legal resident of ~ -
caer) (sae.)
resided at 3 0 1 ~ . Nowever, I have changed my domicile to ~
tsu.~ ma Nome~~
and am and have been a bona fidc residcnt of the State of Florida since ~ s~ day of
3 3 ' ~r~
~~~'V ' , 19~ and i reside at ~ -
(Stnet aad N bsr)
~~2.~ ' ~ St. Lucie County, Florida,
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~nd this statemcnt is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Floiida. ~ , -
(lasert l~ere sn7 pertineat tscts. such as sak ot p~opertr ot businas. or rNiaquahmeat ot employment at tormer
• domic~e. remoral of tsmily to nrw danic~e. PurcAsse of Aome. ete.)
• HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ .
If entering children in school, -
please list their names: ~
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IIOC~R i~ORRAS
. ' C~ERIC C1~CUR COUitT
" flF.CORD YEPIf1E0~
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I FURTHER CERTIFY #hat I will register at my local address when the registration books reopen, and
' comply with ail other requirements of a legal resident of this State. ~
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and i intend to remain in
p ~ ST . LUCIE County,
, ,
Florida, permanently. cc~tr) . .
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. ~ . ; . n ~ S IGNA1`URE
:=.~~`'~;~~3 ce''~.,
.
S~pr~i;t~~nd~~' ~~~,d before me this day of • ,
• ~ j ~ .~,G r~
~ ~ ~4 3 3 I ~
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: _ . _ ,
' ' A.D. 19
: ~ ng r s
• ~p0~ - ~ ~C'LERK CIRCUIT COURT ~...~,y-- ~i,~~~ Florida
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~j~~. . W puty Clerk .
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(To be e:ecutcd in duplie~te and ori6lnal filed witb Clerk t'ircuif Court, aad duplic~te with Ts~i Assessor)
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