HomeMy WebLinkAbout1869 ~
D~cf~r~~i~r~ of Qar~ECile ~nd Citizenship
'fU Tlil: STATI: ANU (~~un-r~~ -rnx nsst~ssoK, 259414
- ^-ST. I.UCIE C'vUN"1'Y, FLUItIVA: ;
,
. Tl~i~ is my drelaratic~n ot' I)omicilt: and Citinnchip in thc Statc of rlorida that 1 am filing this day in ~
;
accorclancc, and in conformity with Sc~tion 2~2.17, Ftorida Stat~ttes. ~
i
I was forn~erly a Icgal residc~~t of ~/.a.~ , ~,~,~~Q~,r`-~--~~ ~ I ~
(c~~r1 7~ (sace~ ~
resided at . However, I have changed my domicile to
(Strcet anJ Numbe~)
and am and have bce;n a bona fide resident of the State of Fiorida since day of
, 19 - and I reside / ~ ;
~ ~ (Street and Numbet) i
' f, ~~o~ St . Lucie County, Florida,
( ~y)
and ihis staiement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. -
(Insert here any pertinrot facts, such u sale of prope~ty or busincss, or telinquishment of employment at tormer '
domicile. remoral of familr to new domicite, p~rcAsse of home, etc.)
ST~l9~li rOyM#~ 1L~
ROCER ?O+TAti
CIfRK Ct~ttfti COU~T ~ ~
REr,nF~ v~?+~IfO ~ ;
,~q, ~0 12 PM'73
259g14
.
~
t
1
E ~
` ~
I FURTNER CERTIFY that i will register at my local address when the registration books reopen, and ~
~ comply with all other requirements of a legal resident of ti~is State.
i
~
~
~ I FURTHER CER~FY that I ha~•e no intcntion to return to my fornler domicile, and I intend to remain in
0
~ ' ~~.b~r • St. Lucie. j
~ 7-_ : ~ , ~ , County,
` Florida;ySermanently. c~'~r~ ~C eo n~a r d- j3li f~- e~
~
- .!J~=~r~.~
; . c (Name)
: ~ ~
; ,,,,,,~~1_, , ~ru : - .
; , =C~'"~,.
4 .\,;:~\)ti~. •rGry~~~~ ~I d~ ~dQj.+2,~ ~~~.e~ j/
; : w'~. • t . ~ ti ~
~ = . i :
s - Swuttt-to:a~i~sa ~S "d bcfcirc mc this _ 2_~ da of •
i - ~ .,a~. L; . _ ~ 1~ - ~ y
- ' ~ c:~.'S'~' -
r ~ _ A.D. 19~~.
v ,r.
` ,~~'R;~f. • CLERK 0 CIRCUIT COURT -
~ ~ - - - - - - - - - -
' ' i ~a~x~c~.ca:x ~ ;~:rc~c
' 13 •
3 . - - - - -Ue ut Cler.k
Y M~~E~ i.r,K~.~r2~ ~
(Tu hr execuleJ i~~ dupfi~alr .~nd unprn.d fdrJ ~?ilh C'Irt{, ('~rcuil ('~~url. anJ duplicate wilh Tax Auessor)
~
~
~.`"'v , ~ '
*L 3_-" `-.',':;"'c"~ . w ~ - ~ d ~s.
h~
. _ _ .r~.a.+.