HomeMy WebLinkAbout1759 (~t?~:~.-^,~~'c~. tE~1~ C~~i ~Qiti~:~z~ c:~e~ ~:i~~~~:i;~~ ~i~
~~o •riii: s•r,~~rt. nnu couN•rv •r,~x nssissoit, ~;3~i?~3
_c~oun•rY, i~~oiiiuA: .
1'I~is is my ~Irrl:ir:ition c~f U~mirilc and Citiicnxhip in thi Stat.• of Clorida lhat I am Clin~ this day in
accotd:~n~r, ,iiul in conformity ~vith Scctioii 233.17, rlorida Statut~s. `
1 was fornicrly a I~•ral residrnt of ~-~lU~~li~S• , D~a and I
(citr) (state)
residcd at .,~,~9~ ~~i~tJ~ y£~ . Ho~vcvcr, 1 ha~~c changcd my domicile to
(Slrert and I~umbrr) ~
and am and .havc bccn a bona fidc nsid~nt of thc State of ~lorida since day -of
, 19,~~, and I residc at ~ ~ ~
~ (St~eet snd NumDer)
~ .
/-"~f.~l' F • ~ l~~.C~~ ~ County, Florida,
co~r)
and this st:?tement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
.
(Insert here any pertincnl facls, sucl~ as sale of propcrty or business, or relinquishment of employment at tormer
domicue, removal ot family to ne~v domicile, pu~chase ot home. rtc.)
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~ ~ FILEO AKD RECOit0E0 -
~ ST.IUCIE COUNTY FLA- G~
ROCER P01?RAS
~ FtECORO YERaf1E0 COURT •
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I FURTIiER CE1ZT[FY that [~viU rerister at my local address when the ngistration books rcopen, and
comply with all other requiremcnts of a Icg~l resident of this State.
I TURTHFR CERTIFY tliat I lia~c no intcntion to rct~urn to my tormer domicile, and I intend to remain in
/i f.Pl'~ , . , . .C.~Ci~ , County,
Florida, pcrmancnU ~ G~~ '
Y' f-~ c I1~N L_ ~
~ . (Name) -
. ~ . AdJress)
S~von~ to and subscrihrd bcforc mc this ~ay of
.
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Nolarr 1'ul?lic Sl~te uf 1 H~tiJ~ al I.arKr
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My Commission rx~,in• : ti ~ •w - .
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(Tu Irr eseculeJ in dupliratr anJ un~in~l fi1rJ ~~i1h ('Irtk fucuil CouH.ly~u~~3~ A~~rssut)
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