HomeMy WebLinkAbout2032 Declaration of D~r~iic~~e and Citizenship ~
. 30~008
TO'fHl's STATC ANU COUNTY 'I'AX ASSCSSOR,
_ ST., LUCIE ! COUNTY, FLORIDA: ~
TI?is is my dcclaration of Domicilc and Citizenship in thc Statc af Florida that i am filing this day in
accor~lancc, ~ind in confunnity with Scction 222.17, Florida Statutcs. ~
1 was fonnrriy a Irbal resident of a r~ or and 1
ity) (st te)
rrsidcd at 3~ . Howcvcr, 1 have changed my domicilc to
(Strcet and Number) +u~
ancl am and l~ave tx'~n a bona fide resident of the State of Florid~ since " day of
, U o5~ , 19_1_1__, and _I residc at ~-Zx~ ~v•
. ~ (Street and Number) ,
o~. , St. Lucie County, Florida,
(c~~r)
and this statement is to be taken as my declar.~tion of citizenship, actual legal residence and domicile in the State
oF Florida.
(lnsert Aerc any pcrtinrnt facls, such u sate of ptupert~' or business, or relinyuishment of employment at former
domicile, remdval uf family to ne~v dumicilc, purchase af home, etc.)
EI~:TCRI;IG CHILDRE?~ IN SCHOOL: HOMEST'CAD EXCMPTIO`I: ~
If entering children in school, ~
please list their names:
30~Op8 ~
FtLED ANO RfCQR~E0 ~
ST.lBCtE COUNTY ftA.
f RdCfR P0ITRAS ~
; CIERK C«CUIT COURT ~
j RECORD YER3f1f0 ,
E
~ F~e 1~! I I oo AM'75
,
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1 FURTtIER CERTIFY that 1 wili register at my local address whcn the rcgistration books reopen, and
~ com~,ly ~vith all other rcquiremcnts of a Iegal r~sident of this State.
I T=URTHER CERTlFY -that ( havc no intcntion to return to my fornicr domicile, and I intend to remain in
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* _ ~~~_~~c~ ~ ST. LUCI~ , County,
~ I~loric~a..rcr,nancntly. (c-~~r)
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. ~ 4-^ .
~ . , S IGI~ATURE
~ . . _ • 4 ~ ~
~ Sw~~~-ir~or~itd ~ubscribed before me this _ day of
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~ ~ A.D. 19 7~_.
~ - -7~G i ing ress
~ ROCF.R POITRAS, CI~lt1: CIRCUIT COURT , Florida
~ By Dc~uty Clerk
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~ (Tu be ezecutrd in ,.~pliraie ynJ on~inal fa~-d ~~ill? Clrtk ('ircuit Coarl, and dupli::ile wiU~ Tax Asscuor)
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~ eoac~6 P~a2030 ~
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_ _ - _ ~ - u::_ _ = 3~~.-~~