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Home My WebLink About2645 Declaration of Qomicile and Citizenship r~ -rtit~ s~~.~-rt~ nnu c~uun~~~~ ~rt~x nssi:ssoK. 24'75'~3 s~~ IGv~' (~()UN~'Y. FLORIUA: 'Thi. i, my dcclarati~>n ~~1 Uomirilr anil Citizrnshi{~ in thc Statr of t~lorida that I;~m tiling this day in ;i~rur~l:~ncr. .u~d in cont~urmity witli Scrtic~n ?,,.17. Florid~i St:~ti~trs. . ~1~ . ~ I ~vas t~ormrrly a Irkal r~sidrnt ot~ ~~2/~- . -~t!-7~- - • - and l (c~n? (stacr) _ ~ lr. 5 S~~6 T/~ ~T~ N~ y ~v. ~.~ono ~ 3, rrsi~l~~l :~t _ t_~_- _ 9 Howr~~er. 1 havi chan ed m domicil~ to ISUrrt anJ Numhrr) an~1 am and t2a~•e br~ii a bona ti~i~ r~siJrnt of thr Stat~ oi l=lorida sinrc __°Z--~--- d~y oi ~ t'~~~ c~~_ oc ?/4 (`A~C'A~tllY4 ~ANc~ STA~c//SN ~A/~'FS T _ _ . i ~ - - :,~,a i ~~.~a~ :,c _ _ (Str rt and Number) ~"E~~ 7" S%. ~v cicF si ~ ~ e~~ County. Florida, ~c'~tv? - • ..~~~t this titatemrnt is to be taken as my ~irclaration ai citir~nshi{~, actual legal resid~nce and domicile in the State ut F=lorid:~. (lnsrr. hrrr an~ prtlinrnt fact~, ~uch as wlr uf pruprrty ur bu+inrss, ur « linyuishment uf rmpluymrnt rt furmrr dumicilr. rrmu~~l nf famih• tu nr~c dumirilr, purrhrcr uf humr, rt..l i FtLEO ati~~ R~CpR~E~ 3T. LUCIE C~L'NTY Ft,~. ROCE~ ?ZtTR~S ~ CLERK C.::~~tT COtNlt Rf.C(T?a Yf.r:,F,cp f~o 9 I~ 31 ~'73 , ' 24~5~;~ ~ ~ E i i ~ ~ a Y ~ ~ i a ~ ~ I FURTHt=.R CI:RTIF=~' ih:it I will r~~~istrr at m~~ loccil adelress ~~•h~n th~ r~~*istration books reoren. and ~ ~c~m{~1~~ ~~~ith all oth~r rrquir~m~ ~its c~f a Ir~~al r~si~tcnt ot~ this Stat~. ~ 1(~t`RTHER ('t:RTli=ti' that I ha~c n~~ iiitr~itiun ta rcturn to m~• fornjrr ciomirilr. .+ncf 1 intend to rcmain in ~ ~ ` ' NUC' /E Sj . .~jtic'/F _x e~T Si• - ('ounty. ~ - - . _ . - k Flori~la, prrman~ntl). ~c~"•~ ~ ; - - -Q ~ • _ - - - - ~;~amr~ ~ p ~n ~ . l~C'~.~ ~QJ ~c-~ `c27~/1~-~,t~ce~~XQJ • • - - - - - ~ . . . 1 Addrcssl , . . : L ~ . ~yvUTli i0'tNa(I suti~-rib~d bclc>r~ me thi~ ~ da~~ of . 1~ . • ~ - - • A. D. I 9~ , - ~ = . : _ _~!~ir%' C : • i iIG'G ..,,ry, ~ . - - - ~ r _ ~~y p~ni~~ si~c~ uf I lurida at cr ~~y~- ; , ~-ll ~`t . . T~ ~ - ~ ~1y (4Ef~lIIAi§~ian rxrirrs . ~ , . . ' (To hr r~rculyd in Juphratr and un~in.+l f~lyd .~~Ih ('lerk l'ircuit C~~urt. anJ Juplicatr «ith Ta: Acscssur) ~ ~ ~s~z , se~~r, ~1v ?'n~~r , - ~ . _ . _ . . ' _ - ._~~b~v.