HomeMy WebLinkAbout1073 Declaration of Q~miGil~ and C~tiz~r~ship
"10 THG STA'TG ANU COUNTY TAX ASSt_.SSOR,
ST. I.UCIE ~ , n : , ~~1
CUl NTY, ~L R A
Tl~is is my dccl,~ration of Uomicilc and Citizensliip in thc Statc of rlorida that l am tiling this day in
accordance,.ind in confonnity with Scctian 222.1?, Florida Statutcs.
1 was fornicrly a le~al residcnt of ~~R W~' G° N/~ and 1
(citr) (Sta1e)
G~Nt~r.;
N > %
nsidrd at ~ . Howeve;r, I have changed my domicile to
(Street anJ Number) ~Z
and am .inc3 havc bccn a bona fidc residcnt of thc Statc of Florida sincc day of
. S_~~~~~ , 19.~~., and .1 residc at Z_ 2~ S~~./= V~ IP G R f-,~ j
E~n'/~ C~
~ (Street and Number)
i ~ i. L v c iE = St . Lucie County, Florida,
(CilYl ~
and this statement is to be taken as my declaration of citizenship, actual Iegal residence and domicile in the State
c~f Florida.
(insrri hetc any {+rrlinrnt facts, such u sale of pru{xtty ur business, o~ relinyuishment of emplo~ment at former
domicile~ re~no~al of family to ne~v dumicilr, purchase of I~o~ne, ete.)
EI~~T~RI\G CHILDREt1 IN SCHOOL: NOriESTEAD EYEriPT7U*I: ~S
No .
If entering children in school,
please list their names:
ST
IUCIE COUN~Y F~A,
CLERKG iRCU1T C URT G
RECORp yFRtFIEO~
• ~
F
f
e t 1 1 1 s9 ~!!'75
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e
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I FURTHt:R CERTIFY that I will rrgistrr at my local addrrss when the registration books reopen, and
comply ~vith aU othcr mq~~iremcnts of a lrgal residcnt of this Statc.
~ I FUR7~HLR CERTIC'Y that I havc no intenti~n to return to my fornter domicile, and 1 intend to remain in
~ _ j ;
~ G v<' i F_ ST. LUCIE Count
- 1 , Y,
~ 1~lorida, pcrmancntly. (c•~~>~
~ ~ J tL~ GiJ ~ ~/'r~ ~ ~
~ • A~ox~- -
~ _~~i~s A
~ -
~ : ; S IGi~1~?7'UR~
~ S~rQr~,tt~'wtiJ.~(ssfribcc: hcforc ~zzc thi. day of
~ _ ~ - _7 ~ 7 ~ Z S t . ~ VG-1: c~ /l'E~ i~
A.U. i9_~
~ `e y! ~ - ai ii~f~ ress
~ •.RCGE}fi,~'1';~RAS, C1.~fiK CIRCUIT COUIt'T D~,?~ J~;, LU~,~~ I~lorida
•"'~~„'Y `i"~'~~~ ' - ~ .
'i/\~~' ~~r {.~E~~~i~y Clerk ~ ~ - .
.y
' v
p? V (?o be eseFpteJ ~n d~~plic:.le a~eJ ~nipinal (drd ~vilh ('hrk Circuil ('nu~l. and duplicalr ~cilh T~x A.sessurl
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