HomeMy WebLinkAbout2619 Qecla~ation of ~~r~icile and Citizenship
7'n Tlit? STA'1'l: ANl) COUN~'Y TAX ASSL'•.SSUR, ~ 3~~4'~ t
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ST. LUCIE ~•UUNTY, I~LORIUA:
'Ti~is is my drelaration of Dc~micilc :ind Citirenship in thc Statc of Florida that 1 am filing this day in
accordancc, and in confonnity ~vitl~ Scction 222.17, Florida Statutcs. ~
1 was tornicrly a lcgal residcnt or and 1
: <c~~r) (s~~~~~
residcd at l.~~0~1°~~ll~-__ _ . f owcvcr, 1 i~avc changcd my domicilc to
(Street anJ Number)
~~nd am and havc Uccn a bona fidc residcnt ot thc Statc of rlorida since day of
, 19~~_, and 1 residc a1S~yS lU• ~Q/L~°~ ~~i9 C~ ~
~ (Strcet and Number)
l p r_~T~~~~ . St . Lucie _ County, Florida,
cc~ir)
and this statement is to be taken as my declaration of citizcnship, actual leg.+l residence al~d domicilc in the State
of Florida.
(Inseri hrrc any perlinent farts, s:~rh u sale of p~uperty or ~usinrss, ur relinquishment of rmployment at fo~mer
dumicile, remo•~al ut faniily to ne~~• Aomicile, purrhau uf home, rtc_) _
E~1T~KI:`.G CH1LLREN I?1 SCHOOL: HOMi.S'i"~:AD E~E~IPTTOy: ~
If entering children in schoo~, ~ _
pleas~ 1 ist their nacr~es : 3Q~444
FILED RHQ fiECOR~EO ^ ~
ST. LUCIE COtfNTY FLA.
- ROGEK PQ~T~AS '
CLERK C:~,;;;Jij COURT p~.~
°ECOR!` YEz'~IEO.~...~,~Q
FE8 Z8 II 37
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1 FURTlIER CL'RTI:'Y thut 1 will reristcr at my local address whcn the registration books reopcn, and
~ rom~~l~~ with al~ othcr rcquircmcnis of a Itgal residcnt of this Statc_ -
~ I FURTi1ER Cl:i~TIE~Y that I ha~•e no intcntir,n to rcturn to my former domicile, .~nd 1 intend to remain in
~ ST. LUCIE
~ O,~'"'~ lJ C / E. - , CountY,
~ Floricla,;[?CTJI)~1~ltly. (c~~~~
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~ ;n~ • • . - .L l - S IGI1A7'URE ~
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~ Swor~i "tb•a~id subscribc~l bcfore ine this da~ of
~ ____f~ B' A.D. 19~~. s,~~~ _
~ _ _ _ ~ - i in~ c ess
~ RC~!:ER POITRAS, CI.ERK CIRCUIT C~URT :~`_y~ I'lorida
B u--~-~-~ Caoz, ~LG~e ~ut y C l c rk ~
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~ (To Ix r:eculeJ in Juplica~c anJ ~,ngin.d t~IrJ ~.~itb Clrrk Circui~ Court, and duplk•~tr ~vid~ Ta~ Ascesvu)
~ 0 R 2V6 PACE261,6
~ 600K
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