HomeMy WebLinkAbout0661 . l'.-\.. ~ ~ .il l'i ..t_:?.~~ .~i.. ~ '.e:... ~ i ~
:.tn~t nr;?, cc;t~r,~~• ~n:~: r. 258596
~uci~ c~ur~ii•, ~to~ian:
lhis is r~iy ~lccl~ration a( nornicilo arid Cilizen:hip in Ihc Stalc af floricfa that 1 am filing this day in atcordanco and
in con(onnily wilh Cliar~tcr 222~ Seclio~~ ?22.17, Flarida Statutes. . .
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I was torme~ly a• Icgal resident of ~~G rj N N~/ A p 4 7
• (City) • (Statc)
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end 1 resided at N~e h ~ I/'e r . However I have changed my domiCile
• ' (St~eet and Number) a C
to and am and have been a bo~a fide ~eside~t of the State of Florida since day of
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,G~ ~t , 19~~, and I ~eside at ~ ~ U /t/ r /-S e- ~ ~ Y ~ '
• (Street and Number)
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FORT PIERCE, SAINT LUCI@ COUNTY, FLORIDA ~ ' ~
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and ihis statement is to be taken ~as my declaration of citizenship, actual lega) residence and domicile in the State of Florida, 1
(Insert here any pertinent facts~ such as sale of property or business, or ~elinquishment of employment !
at former-domicile, removal of •family to ~ew domicile, purchase of home, etc.j _ . ~ !
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- Entering children in school : - ~ ~ ~
' ' FILED AMD RECORDED ~ '
ST.lUC1E COUNTY FIA.
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. • + ' CLER~. Ci=it^~Ut1 COURt
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~ . ~ ~ . . ~ 258596 : .
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~ 1 FURTHER CERTIFY fhat 1 will comply with all other requirements of a legal resident of this State.
~ t fURTHER CERTIFY that I have no intention to return to my former domi~ile, and 1 intend to remain in FO[tT
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~ ~iEP.CE, SAINT LUCIE COUNTY, FLORIDA, permanenNy. '
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~~~Qr ~~`e~d,~~ribed before me this 1 day of , 19.~~ ~
'u; ~`~,tSflt!1~ C ~N~~t~t ` ' -
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~ ROGCR POITRAS ~
~ ltlC CIt:CU ; COU Notary Public
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~ L' y C ~ D.C. My Commission cxpires
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(To be oxoculed •in duplicale and ~••~n (il~c) with Cle~k Circuit Courf, anJ duplicalo wiih Tax Assossur.) .
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