HomeMy WebLinkAbout0806 • 1. .~..Zj ~.'l ?-~.:t.~~. . c.:i_~ .:~1.~.~1~ Lii .
> 11 i! :+il~i L ~1t~h C( l!' ! l i 1l.:•. .
~uci~_ cuvc~~,, r~o~~~~,~~ 258598
lhis is my ileclaration al [)omi~ile and Citimnshi~ in thc Statc of Floricla Ihat 1 am (iling.this day in accorcf~nccs a~ci
in conformily with Cl~apt~r ?22. Scction ?22.~7, Florida St~~tutcs. .
I was formcrly a ICCJJI resident ot ,s,.~_
' (City) ~ (State)
.
and I ~esided at ~ . Nowever 1 have changed my domiCile
' ' (Sireet and Number) •
~o and am and have been a bona fide ~esident of the Staie of Florida since ~ day of
, . /
~ ~ , 19.z.~, and 1 reside ~at ' , ~ 3o S~9
. . (Slreet and Number)
~ -
~ORT PtERCE, SQINT tUGtE COUNTY, FLORIDA • -
and this statement is to be taken as my declaration of citiZenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
af forme~ domicile, removal of family to new domicile, purchase of home, etc.) _ '
• . : -
~ Applying, for Homestead . ~ - ,
- Entering children in school : ? . - -
~ . G~-~
e ~ . ' ~ .
~ . ' • ~ Z~~I,/ [~L,~(,_i - ~ - . ;
~ . . ,
/ • •
. . , - ,
• ~ . . ' .
I fURTNER CER7IFY that 1 wil) comply with all other requirements of a legal resident of this State.
i -
: ' .
; 1 FURTHER CERTIFY that I have no intention to return to my former domiCite, and I intend fo remain in FORT
! PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ' ~
i
FIL~D ~h~' RECORDEO
• Sj ROCE 41NRAS ~it~ G~.J ~-'7t~ ~ a~-~
; CLER~ C:?CU~T COURT (Name)
' ~ RfCflR? VFR~ffEl~ ~ . - _
f - . - .
- ~x,12 10 os AH~'13 ~ - , 30 . ;
. ~ ~ ~9
• ~raK7s9S (Address) _
Sworw~4o.and subscribed before me this - ~ day of , ~q
-t ~ t y 4: . •
,t, r~'' ' • _ -
: ~-s :it(~GIR' ~CS4~,Rl~ ` '
.
~ C~:ERlC. CIRf~t~f CCSIRT Notary Public
~;:i \i. V. +Y ~ ~ - , ~ .
, - b.C. My Commi;sion cxpires
. .
•C~,, ~ .
~ •
(To be oxocuted •in duplicale and ~~•~na) til~cl wilh Clerk Circuit Courl, an~! duplicato wilh Yax Auossor.) V
~ ~ 8otl ,
r;f'~ .
~ _ - - r
_ - - -
_ . _ _