HomeMy WebLinkAbout1609 . - `
Qeclaration o~ C3~mici~e and C~tizenship
TO TIiE STATt: AT~iU CUUNTY 1'AX ASSl:SSU1:, 3t~,~~
_ST. LUCIC ,_T_ CUUNTY, ~LOR11)A:
This is my declaration of Domicilc and Citizcnship in thc Statc of Florida that 1 am filing this day in
aca~r~iancc, and in conformity wiUi Section 222. I 7, Florida St:~tutcs. ~
1 was form~rly a legal residcnt of ~ and 1
(citr) (s~ale)
resicied at ~6 9~~ °~~Y -~~'~0~"~ ~~~wever, I have changed my domicile to
' (5trcet and Number)
and am and havc bcen a bona fidc residcnt of thc St:~tc of Florida since ~ day of
, 19Z~, and 1 residc at 8 O N. .s'~!~? ~ C[ R c t, C
' ~ (Slreet snd Number)
yl~~ _ °~~j~Gc~q , ' St . Lucie County, Florida,
~ (cti~y) ~
and ihis statement is lo Ue taken as my declaration of citizensliip, actt~al legal residence and domicile in the State
of Florida.
(I~xrt here auy ~+ertinrot tacls, soch as salc uf propcrty ot business, or relioquist~ment of employment at formrt
domicilr, remuval uf tamilY ~a ncN~ domicilL, purcl~aa. of home, etc.)
E!`~TERI~'G CHILDREti IPd SC:~OOL:. ~ ~iOMEST'r.AD EXEt~SPTION:
If entering children i.n school,
please list their names: _
~ ~
t °bcr~~E~~ ,
~orE~ tort i
Rfcoieo y c~scwt
c~Rr C `
Fa:f~Ea~
. ~ 19 10 ~ ~H'l~i
;
~ ~
~
f -
~
~
~ .
~
~
~
1 fUKTHER CERTIFY that I will register at• my loral address when the registration books reopen, and
romply witli all otl~er rec~uircmcnts of a legal resident of this State.
~ I FURTHER CERTIFY that 1 havc no intention to rcturn to my former domicile, and I intend to remain in
~ ~ G~C~.~ ~•L~X~~,,~~,,_.~ _ ST. LUCI~ County,
~ Florida, pcrmanrntly. <<'"~ ~
~ tL~~~ ~ ~
~ ~ ~.rp c i ~t L p) ~ ~
~ - .
~ ~ f:~~r,~`s~.' _ _
~ • G'•'xi~Z''• ; ~ GI~AI'ilIt~
~ _ ~ ~w~0.~,?~
~ S~vQr~t:~~~nd subs~7~cc1 eforc mc this day of
~ • ~ .
~ _ - . ' * M ~ ~ - _ A. D. : 9_ 7~ 4~~0 N r ~e o~a ~,e~~ `
~ : ~_:,..w. , f . rl; :~{.f ing ress
~ R ~ jt CI.rRK i R~UIT COURT ~J~c. ~~C• ~ :
_ . - , Flor~d~
- .
.
~:F~ 3~~ ~ ~ .
~y ''~'~t{~„ I ~uLy Clerk . . ,
~ ( o t••• cx. ted in dus~h rnJ ~~ri~•in:J tileJ ~ci~4 C1rrk Circuit Cour1, anJ duplkate wilh Tax Acseasn?)
~ go~C~ r~~.~
~
~
. - - ~ - ~ ~