HomeMy WebLinkAbout0656 ' i ile and Citizenshi ~ ~
Deciaration of Dom c _ p
'PO THE STATE AND COUN'fY TAX ASSESSC)R, ~~4SS
ST. LUCIE CpiJ~y, FLORIDA:
Thi~ is my declaration of Domicile aad ~tiunship in the State of Florida that 1 am fding thii day in
acoordance, and in conformity with Section 222.17, Florida Statutes.
1 was formerly a legai resident of ~-1 / ~ • ~ N , ~G = md [
• (a~s) (s~.e~)
resided ~ at ~~A-~~ p, 1 e~ . How~,wer, I have changed my domicile to
r (stnsl a~d Nw.wr)
and am and have been a bona fide resident of the State of Florida since 3 day of
~L~ 19?_Y._, and I reside at Y~~/ ~f .S ~•o-b~ ~ L,¢-~..~
' . (sa~,.a N~ea)
~G~ t- t G L~,{ St . Luc ie County, Florida, ,
T- . (cier) _
and this statement is to be taken as my deciaration of citizenship, actual legal residence and domicile in the State . ~
af Florida. - .
(lnat ~ae awr Pestioewt facts. s~d~ ss sde ot pcope*tT ar b~si~e,s. u~ tNaquisA~eet oT e~pbTaa~t at toraer _
do~icie. reaioval ot hauh to wewr doAin7e. PorcYase d Mow~0. ete.)
• HOMESTEAD EXEMPTION: ~
ENTERING CHILDREN IN SCHOOL. ~ .
If entering children in school, ~~-1
please list their names:
1
~
v_ r~ f c. J_ G/.a..- k .
~d d ,L J~li~
.n~ .
ftlf0 A*t~ REqiltQE - v,
_ ST. l8~lf C4INITY t
RO,SE=. i:i1~R~S
CIE~i~ Ci .Gsl~T CO!!!1T
. - . Rf~nR~ V=,~FtES~
` ~ ~ ~f 5a ~'7~
f ~ .
f '
! _
I FURTHER CERT[FY that .I will register at my local address when the registration books 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
P•• r sr ~•-s. ~ ST. LUCIE , CountY,
Florida, permanently. ~
_ '
J - ~~-ln.~ ~ ~ Z~~ ~G
~ ,iti~ri.s ~ j!~~` ~ S 1
.
. ~v~
~ ° _
~ ~-~......~~5`:
=~3 :-'r~~~'' ::C'~::~~,': $ NATURE
_r'~~' , =z .
~"K,o~r~~+ty_=.atids~~~~i~ed before me this day of
`y.+~~- 'Y~ra=a,~~ = ~i J
~•'~f- f ';'L,:..:~~ir~2~i / /ri ~a 6~ ~G :~~1~/~~~.~
: ~ ` _ ~ _ A.D. 19
' _ing li~[1rCSS
: ~~.~:.ti}iL~ ~'g - ~ ~ e - ~
Q~it~~ CIERK CIRCUIT COURT S- ~ Florida
~.~.t. _ ~_~t_~..:..i -
~"'~.iti.. ~
e
gy~ ~ ~ Deputy Clerk :
i .
(To ee ec~ted iw drpiicrie aad oriEi4a1 tied wri~w t]e?t Cicuit Co~ut, sad depNrste ~vitA T~ Aaieaso~)
~
~ i~.•,,:
z~.
- - - - - -
° ~'m ~ : ' - ~ ~ s-"~r
- ~
~°E:~~.~"c~,~a";.._ . . . . . _~~4~.aY,. '