HomeMy WebLinkAbout2020 . . . . .
D~clara~~or~ of aa~r~sc~le and ~~t~~~nsh~p
~ro Tiit: s~rnTC nnu c•~un•rY ~~nx nssesso~t,
sT. Luc~r ~~9~ `
CUUN~'Y, FLOR11)A: ;
'fl~is is my dr.rlar,~tion af Uomicilc and (.'itizcnship in th~ Statc of rlorida that 1 am tiling iliis day in
accordancc, and in conformity with Scction 222.17, Florida Statutcs.
1 was formcrly a Icgal residcnt of ~ r _ ,-~`2' "J ~ and 1
~ (CitX) ~ ( a~c)
nnsidcd at ~ ~ ,~/~1= £ h~Tf Howevcr, 1 have changcd my domicilc to
(Street and Number)
and am and have been a bona fide residcnt of the State of rlorida since f day of
- _ , 19_r~ and 1 reside at ~Srr ~a ~e-~ n Oq~ ~
~ (Street and Number)
% ~ US.r E , St. Lucie _ County, Florida,
(~~r)
and this statement is to be takcn as my dedaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inseri hcre any pr?linent farts, such as sale ot property or husiness, or rclinquishme~t of employment at former
domicile, remuval uf family lu ~~c~v dumicile, purchase ot hon~e, etc.)
EI`~T~RIyG CHILDREN IK SCHOOL: rj ~ ~iOI~S'1'EAD EkEriPTIO*i:
If entering children in school,
please list their names:
~
f~~o ~MO Rfco~ D
sT. aoci~a
P41TRA~u
CLERK C1R(fUIT COURT
' lIECORO vER1FIE0
~ f~e Z~ t0 zi ~M'~5
.
~ . 3t~.99''7
~ . .
~
~
1 FURTHER CERTIFY that 1~vill register at my local address when the rcgistration books reopen, and
comply with al) other requirements of a legal resident o( this State. ~
1 FURTHER CL•RTIPY th.it 1 have no intcntion to return to my fornier domicile, and I intcnd to remain in
C~_ ~ ST . LUC I~ , County,
~ Florida, pcrmancntly. ~~'~Y~
~ ~ ~
~
~ - -
,r` ~ . - ~
~ ~S•''• Y.~ 11~~. - • '
w: r.~,;;-''~`` ~o ~
~ ~ L
~ , • • ~~U~-'L..;:, ;t;; ~ ~
' /~~~~1
~ ~4 _ ~ SIGIdATURE
~ . ~ A.
~ ,,~woN~1:Cp.an$~u`~'ii ~'~rc1 beforc mc this da}~ of .
~ ` ~~f ~ ~~2 ~j~~nry/ 0 f-. p.
' , A.U. 19__T~ U
~ - "..s. ~ - - i ing ress
~ R(1~~1~.,~~'~RAS, CLi~RK CIKCU~ T COURT vrt~~~G/ Florida
ny eputy Clerk -
~ , (To be exec tA in duplicalr aia! oriKinal (ilcd wilh ('Ie~A ('ourl. ~nd Juplicale wilh Tsa Assessot)
~ ~~236 ~20~8 ~ : , , . .
~ -
. . : _ - - . - - - - - - - - - _ ~fl~
_ : _ . ~ ~
_ .x.L, .