HomeMy WebLinkAbout0101 ~
c
1.
Dectarat~Qi~ of DamiciEe ar~d Citizenship :
~
"1'U 7'lIG STATI: ANI~ COUNTY TAX ASSL•:SSOR, 30~~6 :
. ,
ST. LUCIE _ ('C)UN7'Y, FLORIUA: ~ ~ ~
~
Tl~is is my dcclaratiun of Uomiciic and Citizcnship in the St1tc of Hlorida thut 1 am filing this day in
.iccorilancc, and in confonnity ~yith Section 222.17, Florida Statutrs.
a
~ ~
t w~s formcrly a Icgal residc.nt of ~~A~--~.----- , C o L~ and 1
(e;tY? stacet
nsided at ~ !!1-.~~1z ~A~~ . However, 1 have changcd my domicile to
Strcet aod Number) e
aizd am and havc bccn a bona fidc nsidcnt ot the Statc of Florida since ~ day of •
~
---c_~.~~.~i /t~__~2'~ / ~
!l'lf~i~t~t/ ~~t/1~~_~ ~
~ , 19 75
_ and I residc at ' ~
(Street and Number) ~
j~`~._~~,~~j~' . St . Lucie County, Florida,
~c~~Y)
:,nd lhis statemcnt is to be takcn as my dcclar~tion ~f citizenship, actual legal rr.sidenee and domiciie in the State i
ut' rlorida. ~
~
~
(Inserl hcre any perlinri~t facls, such as sale uf proptrty oi business, or ~elin~~uishment of empioyment at former
dumicilc, rrmu~~al of fan~ily t~ nc~v domicile, purchase of Aome, slc.)
'T1TI:RI~~G CHILUREt1 IN 5~HOOL: HOMESTEAD EXEMPT7U*~i : ~
L. ~
If e~~tering cliildren in school,
please list thei.r names:
_ 3~2816
~
FIlEO aND REGOROEO ~
• S~. LUC1E COUMTY F~A. . ?
- ~ ROC~P ?pITRAS ~
CLERK ~IRGUIT COURT ~
, 4FCC~D IF?~.~~~rp~~
- Mat S II o6 AM'T
. ~
i a~
! ~
i
~
~ ~
5
~ i
~ R
}
i
~ ,
~ Y
j~ 1
3
~
~ I FURTf1t:R C[:RT11=Y th:~t 1 H~il! mgistcr at my local address when the r~~istration U~oi:s reopen, and
~ comply ~vith a{I other requiremcnts of a lc~a! msidrnt of t~~is Staie.
~
~ I NURZ HI:R CERTIF'Y that i have no intention to return lo my fonner don~irile, and I intend to remain in
Q.
~ _ r'`~ _ -ST. LUCIF CowitY,
~ }~lor~ p~rmancntly. ~c"~~
: .
~ ~ .
. ~ ~~~~u~~ SI~~NATIIIt~-
~ ~ : - _ c~ ~ - ~ -
- L: ~ S IGI~lE?7'UR~
r
Sw~qri~~to :i~fd ~si~bscribcd bcfor: ~n:• this da~~ ot ~
_ ~ . .~''1 ~h,~~-~ A.U. 19_~_~_~__.
• - - ~l 'i l~lif
~ ~ ?"@ S S
= ROG~:R P ITRAS, CLEKa. RCi~Y'r COURT Florida
- - . _ ,
,C~
~ ny ~`t-.~c.~--2. ~s-r~-cTr ~peputy Clcr};
~
.
(Tn t+e executcd i» .!~,;.licate and ~~r~Rin:J filcJ ~v~.h ('IrrA ('ir~ uil f'~~urt. anJ Juplirale Ni1h l ax Asxssor) i
~c~~'3~' ~1 ~ ~ j
~ . ~
~.r . . .
. . _ _ _
_ _ . _ . . . _ -
~ 1~
. _ . L .