HomeMy WebLinkAbout2152 Deciaratian of Domici~e and Citi~~nship
-r~ •rf~t: s~~n-i~~, n~~u c'OUNTY 7'AX ASSI:SSOIt. 266031
St.Lucie, ' ~CUUN"TY, E~1.OR11)A: . °
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"ll~is is my ~Irclaratiun uf Uomicilc and Citiz~n~hip in the Stat~ of E~lorida that ( am tiling this day in
accor~fanc~, and in confonnity with S~~ctiun ''2"'.17, i=lorida Statutcs.
I was font~ly a kgt~l resident of -__-yG2~=.~cu,G~-e- ' .
, - and 1
(ciir) (state) `
resided at ~ K~L - However, 1 have chan ed m domicile to '
(Stteet and Numbrr)
and am and have bccn a bona fid~~ resident of the State of ~orida since day ot' ~
now ~
_ , 19__?~, and t /reside at _.L_~ ~ ~~~J~ Qu-~~ ~
(Street and Number)
.c~ , St. Lucie ~ County, Florida,
(cnr)
and this staternent is ta be taken as my declaration of ritizensl~ip, actual legal residence and domicile in the State
of Florida. -
(Insert here any perlinent facts, sucA as salr of property or bu,inrss. or relinquishment of employment at former
domicile, removal of family tu new domicile, purchase of home, rtc.j
;
Entering children in school: `
,eh/?c. ~~J
t
- ~ f tLED AttD itf GWiD~
~ r[. WCfE Coll~t.r+F~?.
RO~En r~lT~ ~
ELERK Ct3;CUfT COl1it~ ~
RfCORO VEPiitfO~....`.~
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F 1 FURTHER CERTIFY that I will register at my local address when the registration books reopen, and ~
~ comply with all other requirements of a le~_~l resident of this State. '
;
~
~ I F THER CERTIfY that I have no intention to retum to my former domicile, and I intend to remain in
: ~ .
_ ~j.,~ ~ 1 _ _ St . Luc f e
~ , County,
` Ftorida, permanently. (c~~r~
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~ . . {Name)
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, _ ! Y ~ W " G _ L~ .~Cf~ ii~~-'~'~!-'['
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•Y~i ~ C : ,,v;
N (Address)
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S~voit~;~(o:a~~~
_~.brf~rc m~ tt~is cl~iy of
-~-:-=---~~~c?~ P~. n. n. 1~~ _ 7 3__
ROG~~t POITRAS, CLERK CIRCUIT COURT
E ~ - - -
_ . . ~y l~.•~l~ u R 2~9 ~116F~~~~~
~puty C erk BOOK
(Tu bt tarcuteJ io du~~bratr ,rnJ ~r~i~ in,~l fdrd ~~ilh (7rrl~ l'uuni ('uurl. :~nJ dupli: JIC NIIII ~JE Acksti+~r) .
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