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HomeMy WebLinkAbout2675 1 ' M t • /`t ~ ^ . • /1 ~ r t. ~ r. ~ r 't` ~ ~ ~ .1 ~ r -c t • ' ~~`~:~itC-:: G'.1~: ~t ~..`L.1:~ C~?~•.ot:.:r G:~ ?`ti ~.Stt.l.'_~.. ~ 1.:~.~i'~~~ , ~ ' - , •~~o ~i-ii~: STATI: nrr~ counl~~~ ~•nx nssi:sso~i, ' 26215S - ~ ST. LUCIE ~ ' - - ~ ~ ~ _ ~ COUN'1'1';1= LORI DA: 'fl~is is my dcclaration ot llomicilc ai~d Citizci~ship in thc Statc oC l~loricl.~ lhat 1 am filing this day i~t ~ < accordancc, and in confonnity with Scclion 222.17, rlarida Statutcs. , ' and I ~ ; 1 was formcrly a Icg:~l residcnt of ~ 1C ~ S~ d~ ~ , ~ ~ , ~ . . • (citY) i~ (s~ate) residcd at ¢3~r2 S e.~J H r ct " . l Iowcvcr, I have changcd my domicilc to + (Sl~tel snd Numbe~) . • atid am and l~a~~c becn a bona fide residcnt of the Statc of l~lorida since ~ day of~ ~ ~ I ~ (A1 ~ C~- t~.?~ ~J ~ - J_~ r - , 192dy ~ and I residc at ~e ~ ~ (St~cet rnd tiumber) ~'d ~r 1~- `r C~- ST i U.IE County, Florida, (a~r) and this statement is~to be taken as my declaration of citizenship, actual legal residenee and domicile in the State ; of I'lorida. " • ~ - ~ . . . i _ . . ~ (Insert hcre any pertinent facis. such as sale of pro{?etly ot business, or relinquishment ot employmcnt at former _ ~ domicile. temoval of family to new domicile. purchase of home. ete.) . - • - • • ' . _ ' . ~ ' - " : ' . . - . ~ - - _ . _ - . • - . - • ' • -..Applying for homestead : . . ~ ~ . . ~ ~ : ~ - - ~ . ` . _ _ ~ ~ . ~ ~hh_ -~~"~Ain\~~~ ~a _ : -:'~Entering chiZdren in school ; - S e:~ v~`~ ~ ~ . _ : ~ _ ~ _ - . - . _ - - ~ - _ - : - ~ - : . ~ - . . . . : _ . - _ . : ~ ci w~ ~ S ~ - . . ' . . . - - _ . . : ~ . . _ ~ . _ . _ - . . . ~ . ~ . - - - . ~ . : - - ~ : ~ Other: = ' . : . _ - ~ . - • _ ~ ~ - " . - . : - • ~ - - . ~ ' ~ ~ _ . - . ~ . ~ ~iTLEO ~~0 ~tE ~ , f R:=, . - WCtt: C~tlAr - - _ . - ~ - : . ' ~EC~ ~ G 2~ ~IAT l ~ - . - . E . - ~ . ~ ~ - " . . - • ~.y~~~~~~ . . ~ . ~ - . ~ - ~ . ~ ~ . . ~ - ' ~ - ' ~ 2~ 11.9~ ~1!'7 : ~ - - - _ - - . 3 ~ . . . - . ~ ~ - - ~ . - .l - l . : . - - ~ _ ~ - . ~ ~s~~5 . + - : . - - : - _ - . - - - ~ . . - ~ - ~ - - - - - ~ ~ . . ~ I PURTIi~R CERTIFY tliat 1 will rcgistcr at my local address whcn thc rc~istration books rcopcn, and i comply with all othcr rcc~uircmcnts of a lcgat residcnt of this Statc. ~ I rURTIiER C~RTI~Y that I have no intej~tion to rcturn to my former.domicile, and I intcnd to remain in ~ ~ i ,~,r ~ St . Lucie • , County, ~ ~ rloric~a•,~ • ...'iai~Ct+~t)y. ec~~r~ ' ~ S r e ~ p) i . ~ ~ ~ ~ = Q~~ •.OV-, ~~jJ' - ' - . • ; • : `_(1~• ~f. ~ , '.r'ai~~-3_! t:. G :;p~ ' (Nam ) ~ f • ` • 4•` f . ti ~ Itf y * "J~P ! ` . . ' ~ . • ' ` • ' _ ' ` ,J ~ S G1~ :r~ ~c , ri . . . _ . ' ` t ~ ; ~ . . (Addres.~) a ~ > ~~j,+':` ` ' • . ~ S~~rorri'f4i~~-r~~7+~9~~ibcd b. ~orc mc this da~~ of - ~ ~ . . . ~ , s Ff ~ _ _ ~ - /~.f). 19_73._. . ~ : ~;;i ;I;li T'OI'I'I~/~~ ~ C1_l:l~l: C1 .Cl)IT COU1:T g0~K.2~~ PbGf~'6~ . _ • ~ 1., Y~ ~ ~ _ ~ ,~,r ; ~ ~ _ _ . . a-