HomeMy WebLinkAbout1877 Decl~ratio~ o~ Dor~icife and Citiz~ns~~p
'1'O Tlil: STAT1: r~Nl) CUUNTY 'I~A\ ASSt~.SSO1t, Z6rJsQ~i
St.Lucie
- ------coun~r~~, f~~otttun:
Tl~is is my cl~clarati~n at~ Dc~micil~ an~i Citir~n.hip in thr Statc of Florida that I am ru~,~ ~n~s ~iay in
accordancc, and in coniormity ~vith Scction "'.17, I~lorida Statutcs.
I~vas fornierly a Icbal rrsi~lent of ~y' ` and 1
.
(CitY) (Slale)
residcd at j ~_ILl._ Howcver, 1 ha~~c changcd my domicile to
~ (Strtrt and Numtxr) •
and am a~id have becn a bana fide rrsident of the State of Ftorida since ~ 7 da~--e1'-
now
- , 19.~__, and 1 /Ecside at ._~Qa -
(St~eet and Number)
. St . Luc e County, Florida,
(c~cY)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. . -
(Insert herr any prrtinent facts, 5~~n ~s ~.,i~ ~r ~r~~~er~y or Ausinrss, or relinquishment of employment at former
domicilc, trmoval uf family to nc~v domicilc, pu~chasc ot home, rtc.)
. `
FILEO AND RECOR~EO
St_ lUC1E COUMtY fl,~_
ROCER ~~iTR~{S
RE ~RD VER~ FIED COURT ' y
, ~
~
~ Ocr r~l 3 02 PN'T3
~
~
~
~ 26 ~
5808
_
~ ~
: .
~ i
~ •Y
1.
. ~
at 1 will re~ister at m local address wlien the re istration books reo en, and ~
I FURTHI:R CERTIFY th _ y g P
comply with alt other requirements of a Irgal resident ot this State. ~
I;
I FURTHER CERTIFY that I have no intention to return to my fornier domicile, and i intend to remain in `S
. . :
St . Lucie County, ~
~ (c~tr) ' ,
Florida, permanently~.
~ -
~ ,6' ;
.x - ~o _
~s , . - (Name) J
- - ~ ~ ~ ~ ~ D 3 ~iuz~ :
~ ' ~t Addreu) '
_ _ _
: ~ > . ~s, ~ ` = i
~ Swcir.n:~";f~nd sul~s~liLed before mr thi: rL . day of '
~ ;^.:..:~~co,;-;:~~ L 73 '
~
'_~~'t_~,11P/~.--• A.1). 12-
~ . - -
~ ROGCR POITRAS, CLERK CIRCUIT COURT -
- - - - -
~s~ - ~ b+~
~ . . e _ cn EOOK PA6f ~v
-BY--- ~,p~--CTerk - - F
,
(To I~c c~rculcJ in du~~l~~.~lr .~nJ nr~~ m~1 fdrJ n 1'Ic~k ('inuit ('uurt. anJ Ju~,l~.~atr Kilh T~x A~ccs~ur) `
i
Yi
~a
~_~y
~i+ ' n.
~ ~ _ v~"-~'
4 ~ y~".
~ ~ °xC Rr'ti _v , m
~i'%..~.~.~
` ~ .s..~_-, _ . . _u.