HomeMy WebLinkAbout2390 . .
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~r~ ~r~n, s~rn~~~~. ,1\I) ('UU1~~I Y-rnx nssi ssc~it. 259806
-ST. LUCIE - - - t'OUNTI', t~LORII)r1:
This is nty d~•claratiun o1~ vomicil~ ,~nd ('itizen~hi~~ iii lhc Slatr of l~lorida th;it i am filin~; this ~la~~ ii~
.iccord~ince, and in ~oiiCurmit~• with Srction ?".17, Floriila Statutrs.
I was fornicrly a k~al residrnt of _~~'~r~_°_j!c--_-------.---_- , and 1 '
(ci~y) (su~C) '
resided at s~% ~'*~~LE(,fiavt~ D~•_ ,}lowever, 1 have changed my domicilc tc~ ;
(Street and Number) (
a
and am and have been a bona fide msid~nt of the State e~f ~lorida since day o1' ~
i
_ ~ 19 3~ and 1 residc at __,~/o .c~ 1-~~.r ST ~
, (Slreet and Numbrr) i
~ Di~~~,~ St. Lucie County, Florida,
(c~~r)
and this statement is to be takcn as my declaration of citizensl~ip, actual legal residence and domicile in tl~c Statc
of Fiorida.
(Insert here any pertinent (acts, such as sale of pruperty or business, ur relinquishment ot employment at tormer
domicile, removal ot family to nrw domirile, purchase of home, etc.)
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ST~I
CIE COURTY FLA Jla
ROCF? n~tTRAS ~
CLEfiR C;~:,;Uj~ ~OURi
RECGR': Vz~f rlE~
; . .Iu~ 15 11 ~2 PN '73 ~
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~ 259806 ~
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I FURTHER CERTIrY that t will rcgistcr at my local address when the registration books reopen, and ~
comply with all othcr requiremcnts of a legal resident of this State. ;
;
~ 1 PURTHER CrRTIFY that 1 have no intcntion to return to my fornicr domicile, and I intend to rcmain in '
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St . Lucie ~
~ ~i ~~~C.tti~-~ ____y , Cot~~tty, ~
~ Florida, permancntl~•. (c~~r) ~
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~ Swo ' b` rsubscriti~~~orc mc this ~_S__ cla~ of • .
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~ ' • ~ A.D. 19
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~ G~~ CLERK OF C RCUIT COURT
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~ l;y j)e uL~? Clerk 0 R
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