HomeMy WebLinkAbout1702 F.~'~~~c:e"c~`c~~t~ d7 ~~y r~ECi~~ c:e~~ ~~t~;~:~m'~::
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1'O TilL• STATI: ANU COUN1'Y TAX ASSI;SSOR, 2~146.3 '•w
ST. LUCIE ^ (,~pUNTY; f LO1tIDA: ~ ~ ~ ~
This is my declaration of Domicilc and Citizcnship in thc Statc of Florida that 1 am filing this day ,n
accordaucc, and in conformity witl~ Section 222.17, Florida Statutcs. ~ ,
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1 was formcrly a legal resident of • and I
. ~ir) ~s~.~e~
~ ~ i~ f"~l /!7 . Ho~vcvcr I have changed my domicile to
resided at ~o_~ . ,
(Street and Numberj
and am and have been a bona Gde resident of the State of~ Florida since day of
~ ~ , 19~-, and 1 reside at , ~ 5 ~ 3~ ~ ~
(Sl~eet and Number)
~
,~-~Q ~ ST Li1CIE - County, I•lorida,
(c;tr)
and this statement is to be taken as my declaration of citizenship, actua! legal Tesidence and domicile in the State
of Florida. ~ ' -
' (lnsert here any pertinent facls, such u sale ot propuly or business. w relinquishment ot empioyment at fosmer
domie~g. removai of tamily to new domicile. purchau ot home. ete.)
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Applying for homestead : . . . ~ ~
~ _ ~ Entering children in sc.lool : ~
~ ~ ~Other: - ~ _ - _ . - :
. - . - ~ - _ ~ - . =
~ , . ~ ~ ~CLfR1c~tR vR~ . ~ -
~ ~ ~ _ - ~ . . RECORO YEWfIE~ ~
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i ~ : _ - ~ - . ~ ~~C1~ ~1 ~ .
; _ - - . . . ~ ~3 . - . .
~ . . . ~ ~ _
~ ~ _ - - 2~14s3 = - .
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I FURTHER CERTIFY that I will rcgister at my local address when the rcgistration books reopen, and
comply with all other requiremcnts of a legal tesident ot this State.
I FURTHCR CERTIFY tl~at I have no intention to return to my former domicile, and I intcnd to remain in
,
y -2~~~~~ ~ ~ St. Lucie ~ , County,
~ Florida, pcrmanently.
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'~~a - ~ (~rn,~'P-
1 T
~~J: ~~'••CO'•. (Name)
%r ~'•5 1 •'c~ ~ ~i
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~ ~ii''•. r G'. ~1 ` ~ llt~lilu.t.f ~ ~ ' .~l.liCS~
~ : • ~s ! • • _
p • (AdJrcu)
~ ~ ~~~-ysf n = ~ = . . .
Swafy•~~ ~~~~s`~'syt~ Ucforc inc tl~is ~ day of .
, ,y.., , : ~
n.n. ;9. 73 '
- I:OGCR POITR/1S, CLi;1tIC CIItCUI COURT ~
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~ I;Y D~ C 600K (.1~ PA4E~6~ , -
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