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HomeMy WebLinkAbout1982 . Deciara~ion of D~mici~e a~d Citizenship "tU THG STATt; AI~U CUUN'I'Y "1'AX ASSi:SSOR, 265899 St.Lucie CUUNTY, 1~ LORlDA: ~ Tliis is my drelaration of Domicilc :u~d C'itirrnship in thc Statc of Florida that I am filin~; this ~lay in accordanc~, and in conformity witit Scction ?~2.17, r~orida Statutcs. 1 was fornicrly a lrbal resid~nt of _ ,~~~~'yy and 1 Q~- (city) (State) resided at -~7 . However, I have changed my domicile to (Sireet and Numt+er) and am and havc bccn a bom~ fidr rrsident of thc St:::~ of Florid since day of now ~ ~ ~ , _ ~ , 19_ and 1 /~rc~idr at ~ z ~ (Street and Number) ~n~~~z.-~ , St. Lucie County, Florida, (c~ir) and this statcment is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~ (lnsert here any pertinrnt facts, such as ~alr of properly or Ausinrss, or relinyuishmrnt of employment at former domicile, remo~•al of family to new dumicile, purchase of home, etc.) Entering children in school: , G7~z , ~ FILEO AND RECOROEO y'~~ ST.lUC1E COUNTY FLA. i, j ROCER POITRAS ~ ' CLERK CIRCUtT COURT ! RECOR~ V~R'=iED ~ ; ~ OcT 11 I 111 AN '73 ~ ~ . ; ! ` 26589~ ~ ~ ~ I FURTHER CERTIFY that I will rcgister at my local address when the registration books reopen, and ~ comply with aU other requirements af a legal resident of this State. ~ I FURTHER CERTIFY that I have no intention to teturn to my former domicile, and I intend to remain in ~ . , ~ ~~Z~ _ St . Lucie Count ~ , - , . Y, Florida, permanently. <<"''~ ~ . ` : , , . , ~ • t :z/~~-c.--- .t : ;~J' " ~ - 2.~•. (Name) ~ - ~r ..v. = ~.~r' . ~ r _ • ~ ' • n~ • , _ . _"Z ~G ~ ll~s~c - - {1` : (Addreu) SwGy~~ cl• s~N'~e~~bcfor~ in~ thi, cta af a. ~ a~~, ~ . F~ _-~,.tt,,,,4 r-- n.u. _ 73.- ~K ' ROGER POITRAS, CLERK CIRCUTT COURT ~ - - g - ~ _ g~219 1~81 ~ _.I3y_ _ _ _ - . ~(Y1 ~(YlC f'r_.~ !llepul.y Clerk ~ (Tu hc r~rcutrJ in Ju~~li.a~c.~ud ~.r~~•u~.d Idr~l th ~'Irrl. ~'1r~uit l'ourL:md Juph.a~r wilb T~t Acxssur) - ~ ' ~ ~ ~ K: : ~~~~.~:t: _ . . . . _ . _