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HomeMy WebLinkAbout2650 ~ i ~ . . . . , ~ ~ e . ; t . ~'.~'L'~i~,:'c'~:~~1 ~ c'~ C~~i r ~i~ ~'i ~ r'i c:~`t~~~~ t.t ; ~ : ; , ~ w a.r ~Y w t. • ~ . L? ? ' . . ' ~l~o ~i~iii. s•rn~•r nNi~ couN•ri~ ~•nx nssi:ssoiz, ~ 26Z138 _sT. LUCTr __~UVN~r~~; i~~_o~:iun: ' ~ ~ ~ ~ ~ . . ; 'll~is is my dccl:~ration of Uomicilc and Citizcnshi~~ ii~ tl~c Statc of I~lorida that 1 am filinF this da~~ in accordancc, and in conformity with Scction 222.17, rlorida Statutcs. , ~ ~ ~ and I . 1 was formcrly a Icgal resiclcnt of . , ~s . • ci~r) (s~ate) residcd at o ~ . Howcvcr, I havc changcd my domicilc to 1 .r (Siscct snd t~umber) and am and ha~~c bccn a bona fidc residcnt oC thc Statc ot Clorida sincc 7 day of~ ~ ~ 19~.~, ~ and I residc at (Slreet sn umbcr) ~ _ ' ~ ~ti~ , , ~ _ , ST. L-UCTE County, rlorida, c ' r) ~ncl this statemcnt is to bc takcn as my dcclaration of citizcnsl~ip, actual Icgal residcncc and domicilc in the State of rlorida. _ • . - . . . (tose~t here any pertinent facts, sucA as salc o( propcrty or business, or relinquishment ot employmcnl at (ormer , f domicile. removal of family to new domicile. purcluse of home~ etc.) - f ~ ~ - - . ~ . ' - . - • ' . - • ~ . - ~ . . . • • • _ - . • . . _ . • . ~ . A 1 in for homestead : . ~ . . - - - - - ~ - • ~ ~ _ PP Y g . . - . ~ . ~ - ~ . - . : • Entering children in school : ~ ~ - • ~ - . . ~ ~ Other: . . - : . . ~ ~ ~ - . : . ~ . ~ . ~ , ~ . _ ~ . . ~ . ~ ~ - , . . . ~ . . - s11i pcfi~ cou p~°X~~° . - . . AOC R POfrR~,~_:.A. ~ . . _ - _ . - . . - . . . - - ~ ~ c~E~~-~rficuir co~t - ~ - ~ - . ~ . _ . - . ~ . : . - ~ R~coRO vrR~F~EO ~ : . ~ . _ _ . - _ ~ - - _ : . . - ,.~16~Z~~. ;9 ~ . . : - . . . _ . . - - - . . . . :5t~ 7~ ~ . . . = - . ~ ~ - . - _ ~ . . . . - _ - . . - . ~ . : - 26~~;,3g ~ _ _ : : . - - . . ~ . : . . . . ' . • " . . ' ' - - . . - ' . - . 4 . " ~ ' ' ' , ' - . . . ' ~ ' ' ~ . - . • ~ - . . . . _ ' : , " _ . . . . . . . i I I~URT1iTsR CEItT1FY tliat t v~ill rc~istcr at my local address whcn thc rc~istration books rcopcn, and comply with all othcr rcquircmcnts of a lc~al residcnt of this Statc. . . I rURT[ICR CCRTI~Y tl~at I liavc no intcntion to rcturn to my. former domicilc, and I intcnd to rcmain in .;~u,c~- ~ ~ ~ St~.~ Lucie , County, ! = I~lorida, nerm~nontlyN (c'`''~ . ~ ..s . i ~ , ' ' , l ~ 3.~ - . s ~ = V~p : ~ ~1~OG••,j. - ! ~~6.~.~''-_ ; r,,'' , ~ . ? ~r (Name) ~ j ~ y«. , . i! ~ ~ { ~ ~ . - . ' ~ ~s 9 . ~t : ~ ~ /~r ' ~ ~ - ~ (Address) ~ .-1~~t - 'Y' A~ ~ ' . ~ ~ ~~%n ~ ' . . . - • ' lr ' r r~v~t~{~ ~;stit~4cr~~r..d Urforc mc ihis -Z 3 d:~y of - Ct ~ C 9 ~ . . ~ ri . /l.l). 19---73._. ~ ; ~i~ . ~i { ~t +;(~'.;1;1; 1'OI7'lt/~~, CI.1;R1: CT1tCUI" CUU1:7' ° ~ ~17 PAGf ~V 41 ~ ~ ~ ~,-~,r,~ c ~ - T~ ~ ~ Ba~K _ ~ ~;S- :.n , - - rx y,~ .z~, sR • " ' ~~d^~Xs:~%:4 -s~`~ f ~a L '4.r ~`x.ya 4: .1+, ~ ' _ s. . . _ c _