HomeMy WebLinkAbout2467 . . . . . . b'C /
Qeclar~at~Q~ of [~~mic~i~ and Citizensh~p
'1'O '!'I il: STATI: ANU C'OUNTY '1'AX ASSL'SSUIt, ~~~`~8
~Sfi. _LUCIE _ COUN'fY, ~LORII)A:
Tl~is is my dcciaration of 1)amicilr a~~d Citi-r.cnship in thc State of Florida that I a~n Cling this day in
accor~lancc, and in conformity with Scctioi~ 222.17, ~lorida Statutcs.
1 was Cormerly a legal resident of P_ ~~,9 T U~, , /LL D i S and I
(c~~r) (s~~~o~
resided at ~,2~.~_a~~~ e C
r . However. 1 have changed my domicil~: to
trrel anJ NumAcr)
and am and havc bccn a hona fidc r~sidcnt ot tlic Statc of Florida since day of
Oc To ,e e 2 , ~ 9~y ancl I reside at ~.l~
(Street and umber)
~_~~Q 7~ T L v e. _ St. Lucie County, Florida,
(c~~r) .
and ti~is statement is to be taken as my declaration of ciiizensl~ir, actual legal residence and domicile in tl~e State
of Flarida. ~ ~
(Inscri here any pettinrrtt facts, su~h as sale of proprrty or business, or ~elinquishment of employment st former
do~nicilt, remo~al o! fsmily tu ne~v domicele, purchax uf home, etc.)
Er2TLRI"1G Ct[ILDRE!V IN SCHOOL: ~ HOMEST~AD E.~.riPTIU~d:
If entering children it~ school,
please lisL their names:
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~EO ~~o R
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_ , R~ ~~ERK C,FC~~T oouRi
OR~ yER~F1Ep
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~02348
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~ 1 FURTHER CERTIFY thai 1~vill rcgistcr at my local acidress wi~en the registration books reopen, and
~ comply witl~ all othcr requiremcnis ot' a legal resident of this State. . .
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~ 1 FURTHER CERTIPY th:~t 1 ha~~c no intention to return to my former domicile, and I intend to remain in
~ ~O ~2T ~
7~_.~~_ ~ e _ ~ ST. LUCI~ , Coiinty,
~ f~lorida, permanently. ~c~~r)
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& •••;'{;,~si ~ e.u 10. C~, ~'i'~~In?4
~ ~ ` SIGi~1A7't7RE ~
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_ ''vi• + .•••JT-• •J'/.
G Swo~rn'to,~%i~ sirbscti~ed~'bi~'orc mc this day of
_ t. . y- f T.I~
_ T-.~~~~ A.D. 19~.
~ ROG~IL~'^k~~~~ ERK GI CUTT COURT 1-ln~ ress
.
~ , Florida
~ .
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1r 'f
~ By ~ ~ eput;r Clerk .
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~ ( o be e* u: !upliralr and o:iFin~l filcd wilh Clrrk Circuil Cnurf, and duplicale w~Ib 7sz Assessor)
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~ a~236 P~2464 .
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-w:~~.~.(' ....~s. , , _ ~ . . _ . . . _ , . , . .r:5ev.'~"~~