HomeMy WebLinkAbout2782 2083.00 ~t ~
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Lectarc~irion o~ Domicite and Cifiizc:nshi~
TO TIIE STEITE AND COUNTY TAa ASSN:SSOR~
ST. LUC 1 E COUNTY. I~'LO~tTDA :
~ his is my decl:,ration of Domicite and Citizenship in the Stx?te of Florida that I am filin~ t:.;s ci:.y
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aceorJ.~~?ce~ and ii~ coniurmity with Chapter 222, Section 222.17, Florida Statutea.
I «~us fornlerly a 1e~;a1 resideni of______ ______~AIJESVILLt_. ' ~,.~ISCONS 11J =
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(CitY) ( 5u.tc• ) ;
an3 I r~~sided at-----~JC~a_. OAI!CL.AI~ A1VE.1~1U1. . Ho~ve~•er~ T nave chan~•cd m~~ c:ur,:iciic: `
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(Strcet ~nd Numbcr)
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to .i»d am :aid ~~a~ e i~~cn a lwnu iidc, r~~ident of thc, State of Florida ~in,~ c.a~ o: ~
. .._~PR~~..---------~-~-------~----. i~7.1--. and I reside at.------•--QLOCIC--~~B~`_. LOT..Iq - - _ _ _
(S:reet and l~umi~rr)
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~T LUCI~ , ~T~ ._~,VC~~----- - -w.:nt~•. :or:c.,,
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(Cicy)
~iilii i:lla S::1L~Ilic'I~L l3 LO bt,' ~iC@Ti as niy decl.iT~LIOIl l~I cltizenship~ ACtU:ii i~otii ic'5:i181~i:v .i::ti ~iv..:.~,.~ iS:
.ne 5ta:e of ~'lorida.
~Insert here any ~ariinent tacts. sucn r+s saic of prupcrty ar ~~.sir.c;s, or reu. yu~b~unent ot un~;~:..;.:i~nt a:
formz; domicile. reraoval of family to new .~omicile, purcnase of ho~ue. etc..)
I I~~vt PuRCNAS~D TNIS PROPEQTy~ IuTiENi~ Ta gwt,"D A NOME On1 ~ i AND R~ i iR~ `
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TO << AFZ'tR RETIR?NG FR~ri M t TQRY SfltviCE. ~
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FILfO AkD ~ECORQE~ S ~
ST.lUC1E COUNtY fl~• ~
ROCER ~01TRAS
CLERK CIRCWT COURT
RECORD VER~FIEO
. AeR 23 ~0 i4 ~N't I ~
2a81~?O ~
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I F'u.:T:IER CERTIFY that I witt register at my local address whc~n th~ rea:st;ation ~~.ok; reu,,~n.
ar,a comply witti alI o~her re~uirements of a legal renicient of t'riis Stute.
I Fi;itiTiiGR CER'~'jFY that I have no intention to retuni to my former.iomiciie, and : 1~:i~-.:.; to -.•.:n~a:i~
y
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( city) s
jriiRi"?I1Cllt~y. - - - . - ~~vl~ ~
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C~t?'lL.~~. ~ytf~ _ ~,~-K_.~~'~_3r LOT Iq~ poAT.~T.I..uC~i.~ ~4oR~,DP ~
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~~~-urr, w anci suoscribed before me thia_~Sl.~_day of ~
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~~a~or, . ~~~nl'r~ --CU-- -iQAC_1-.~.~__ o ~
. otxry I'ubi' bt~to FioriJ~ at Iary~e a~
:ti;; C'ur.~t.i~~::iu1l rXpif~~s
("iu Lc c~xecutcd s~~ du~iicwto knd uriyi~~ai filc~l with l'~cric C~rcu~t Court, nnd ~tupuca:e w~th ~~.x As;.c....,.,•,
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