HomeMy WebLinkAbout0994 D~c~us~a~i~r~ afi Llorr~;~~~~ ~nd ~itE:~ ~€~s~~~,~ 263030
7O 7'1!h S'1~~~1')• A\!) ('UU1~7'Y '1~~~\ ASSI :SSOIZ.
St . l.uc ie
. - COUN~I'Y. ~~LU1211)A:
"CI?i~ is n~y ilr~laratic~~i of I)umicil~: ,ind Citi~~».hi~, in lhc Stat~ c~t~ l~lorida that f ai~~ filin~; this d~~y i~~
..~~tiri 1~••~: ~ in t~nnfnr~nitv with ~~'C~1OIl ?~1. ~ 7. ~'~OI'1~~:1 .S1:1Z~11CS.
1 w~s fonncrly a Icga) residrnt of - - , and t
~c~~r) (s~a~~~
resid~d at ~ 4~?
~_SR~ . i lo~vcvcr, 1 havc changcd my domicile to
' (Strcct nd Numbrr)
-
and am and have becn a bona ~de residcnl of _ ihc Statr. of I=1arid.~ since day of
now •f~~
, 19_~
~ , and I /~-eside at -
- (Strrct and bet)
~ St. LuCie Cotmty, Florida,
- - -
(c~~r)
and this statement is to be taken as my dcclaration of citizenship, actual legal r~sidence and domicile in the state
of Florida.
(Insert here any prrtinent facts, such u salr ot p~operty or business, w relinquishtnent of employmeat at tormer
domicile~ remu~'al of famity to ne~~ domicile, purcAase ot homr, rtc.)
Entering children in school:
~ ~ ~
~ 2~~(1.'~n
~ a~ut
r
CfR P~~T$~~~ .
~C s:K ~C~'CUIT ~1~1RT
~fc~o vF4'~~EO
~ ~I 0~ JI~'73
:
~ :
- ~
,
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; 1 FURTHLR CERTIFY th~t 1 will rcgist~r at my local address ~~~hen the registration books rco~en, and
~ comply with all other requinments of a le,~al msident of this State. .
~ I FURTHER CERTIFY tijat t hare no intcntion to return t~ +ny formcr domicile, and ] intend to remain in
€
~ ~ St . Lucie
` - ~ ~ ~ ~
- ~ _ County,
t Florida. pcr~nancntly. (c~~r~
~
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. ...,~~~'/i: (Name) NE /,lN
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~vorn: ~ ~~~ribict i~~t~ore ~~t~ t}~i. _ _ . ~f.~y ~f -
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_ _ _ , - . A.U. 19 73
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~ RL~Gr~i~'.4T~tt~=.: , CLrRN. CIRCUIT COIi~;T
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