HomeMy WebLinkAbout0539 Declaration of Domicile and Citizenship
' Z96369
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE CpUNTY, FLORIDA:
This' is my declaration of Oomicile and Citizenship in the State of Flurida that I am filing this day in
acxordance, a_nd in conformity with Section 222.17, Florida Statutes.
i was formerly a legal r~sident of rt~~~~~ - •C = and I
(c~er) tst. ) .
resided at .~Gl.~~ . However. I have changed my domicile to
(Stnet ssd Nua~bs~)
and am and have . been a bona fide ~~esident of the State of Florida since day of
, l 9~., and I reside at ~ 9 D ~ ~ ~ ~A .
~ ~w.~t.~a ~~men)
. e,. ~ St . Lucie County, Florida, ~
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and this statement is to be taken as my declaration oi citizenship, aciual Iegai resicience anci dvmi~ite in the.State
of Florida. - .
(lassrt bae snp pertiaent tacts, such as sak ot Propertlr or business. or reW~quisament of ea~ploya~eat at former
• domk~. remoral ot faatiry to aew domieile. purchase ot home, etc.) '
LDREN IN SCHOOL: HOMESTEAD EXEMPTION:- ~
ENTERING CHI ~ ,
If entering~children in school,
please list their nsmes: j~~~9
- FItEO AN~ q~COROE~ _
' ' ST.lUC1E "~~HSY FLA.
t.! A i~ A~ Q/tJl.t/! . 1lGvE~ rJ1iRAS
CLER?~ ~~~~j COURT
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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 legai 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,
. i ~ ~ (c~cr)
k~o~a~;; ~ at~rst~ly.
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`'`%'Jr .G9;~~.- ~ . . . SIGNATURE - .
Swor`n`~Ci'atiti~ subscribed before me this °2 day of .
~ ; A.D. 19 74
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ROGER POITRAS, CLERK CIRCUIT COURT , Florida
g ~ Deputy Clerk _ : - .
(To be t:ecuted in duplkate and oti6inai filed with Cletk CircuN Cou~t, sad duplic~te with Tsx Asseswt)
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