HomeMy WebLinkAbout2191 I3~~~~~~r~ ~;~n e~t Doa~tic~~~ an~ Ci~~zenship
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ST. I.UCIE - - _ ('Ol)N7'Y, !~1_U!tlUA:
"Tl~is iti iu>> ~crlaratiun uf 1)omiri{~ and Citiirnship in th~ Statr of florida that 1~m filing this day in
accordai~c~, .?nd in c~nlarmity ~~~itl~ Sccti~~n ?~?.17, Florida Statutcs.
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1 was fornicrly Ic,,al residcnt of __~~QC- ~S U~ ~~C' ,~111"~~ ~?"Olr1TQ'and I
C (city) (state)
resided at ~_~S~Q _ . However, I have changed my domicile to
(Streel and Number) '
and am ai~d have l~~cn a bon~ fide nsidrnt of the State of Florida since a~ day of -
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-JC~~(A.~~i ~ , 19-- and 1 reside at ]0 5 ~ ~v ~
(Stteet and Number)
p~~~ St. Lucie County, Fiorida,
(cHY) ' -
and this statemcnt is to be taken as my deciaration of citizenship, actual legal residence and domicile in the State ~
of Fiorida.
(lnseri here any pertiornt tacts, such as sale of property or business, or relinquishment ot employment at former .
domicile, rrmoral ut family to oew domicile, purchase of home, ete.)
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ST. LUW~ C~JUMTY fLA. ~
ROCE~: f'~?~TRAS ~
CLERIi Cj~'~UIT COURt ~
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~ I FURTHER CERTIfY that I tivel! register at my lo~al address wHen the registration books reopen, and ;
; comply with all other requi:ements of a Ieg:it residNnt of this State. ~
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~ I FURTHER CGRTIFY that 1 havc no intcntion to rcturn to my former domicile, and 1 intend to remain in ~
St. Lucie " ` ~
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, Cqunty,
Florida, pcrn~anently:_ . «'`Y~ `m e s r~~v+d R e~ ~
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Swo"r~r~~,~'~~„ti `~~forc mr this~?____ da of •
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ROGER OITRAS, CLERK OF C RCUIT COURT
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(To br rara•nted ~n Jty.lic.Hr ~ud ~~ti~ ui.+l fil.J ~vi~h I'terG ('itcuit Cuuil, anJ duplirate nith Taz Assescor)
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