HomeMy WebLinkAbout1471 Declaratios~ of Dor~~~cilE and CitE~~nshep
"1'O THE STATI: ANU C'OUNTY 'I'AX ASSL:SSOR, 265483
St Lucie '
~ _ ____~__COUNTY, f~LORI[)A:
Tl~is is my dcclaratiun of Domicilc an~l Citiz~ntihip in thc Statc ot' Florida that 1 am filing this day in
accordance, and in conformity with Scction ''??.17, Flarida Statutcs.
~iPE' U N r f~ , f'ccw o/e and I
1 was formerly a Irgal residcnt of
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resided at 3 3 U ~ S 7~iv u f . Ho~~•ever, 1 have changed my domicile to
~ (Strect and Numbrr) ~
and am and have becn a bona fide nsident of the State of Florida since ~Z_~ day of
~ now /
~-J~~/~. , 19~J and 1 /reside at 3v G ~5 (,'~.,~o v ~ ~v
~ ~ ~ n/ E'.~
n ~ (Sireet and Numbet)
ro,P f u c~ r~ . St . Lucie County, Florida,
(a~y) "
and this state nt is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~ '
(Inserl here any perlinent facts, such as sale of property or businrss, or relinquishment of employment at former
domicile, removal of family to ne~v domicile, purchau of home, etc.) ~ ~j w
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fILFO AND REC9It ~1
ST. LUCIE CpUNT1?
R~EF POITRAs ~
CLERK CIRCWT COURT
RECOR~ VE~~F~EO
OcT 9 9 3s AM'13
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~ 265483
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I FURTHER CERTIFY that I will register at my local address when the rcgistration books reopen, and
~ comply with all other requirements of a le~al resielent of this State.
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~ t FURTHER CERTIFY that I l~ave no intention to return to my former domicile, and 1 intend to remain in
~ ~ ; , ~-T, L v c ~ ~ ~ St . Lucie , County,
~ Florida, permanently.
- . . ` GDc~-y y ~ Y-~'
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. ; Cr'•• /
:r . • (Name)
a • . ~~~Ct~~ll ~ ,IC_ -
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Swor~ to~atu4~i~scribcd beforc m~~ this 1_ day of
\'S , . ~'r .
yy~ - , ~ \
x ~ ~ i`~ 7~ 73
'_~~Z;~, n . 1 r~' ~~-L'-- A. U. 19. -
~ ~~'~tC~GCi~'POITRAS, CLERK CIRCUIT COURT .
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_ . 8~2~9 ~~1~`7~
~ . _ By_ ~{r t - - c
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(To bc rtcccutcd ~o dupGia~c ~nd uripn~ d fdrti ~ti~th l'IrrA (lrrud ('~~url. rnJ duph~rlr w~th lai A~+cs~~~r)
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