HomeMy WebLinkAbout2652 ~~'C~~.?
cZ. ~tG~i1 Qf QEa~"c c~t
~aI Eti::~:~~~~
~ u~ri ~c s~rnT~ nNU c~u~z'Y "I'A~ ASSI :S~OR, 26?639$ '
St .Lucie _ GOUN7'Y, !~l.Oltil)A:
Tliis ic my c)rclaration of Domicilc :~nd C'itiic~~,hi~~ in th~~ St:itc af l~lorid:~ that 1 am ~iling thit day in
,
1 }
.~<<onl~ncc, and in conformity with S~rtion ~?2.17, Flori~ta Statutrs.
" ~r-.
1~vas formcrly a Icgal msidcnt of _ ~1~`~ , R%~~- and 1
r-------- (c~ty) • (state)
r~~>~a~~ ~c ~t~ H~'~~ . Howcvcr, 1 h~vc changcd my danicile to
(Sireet and Number)
~:nd am and liavc bccn a bona fide residcnt of ihc Statc of Clorida sincc ~ ~'day of
now
, 19~y and 1/~reside at ~ L\a ST A~~ ~
' (Stteet and Number)
~ St Lucie
_ F'S ~ ~ \ ~2C i-. , • _ County, rlarida,
~c~~ r) .
:~nd this statement is to be taken as my declaration of citizenship, actuai legal residence and domicile in thc State
cf Florida. - ~
(Insert here any pertineot facts, such as sair uf proper~y or busirtess, ur reiinqnuliment oi employment at tormer
domicile~ removal of family to ne~v domicilr, purchase of home, rte.) :
Entering children in school: ;
~-R ~ ~~r. ~ ~ •
~ ~.-~~~J k
~ -
c~_~ . ^ 13 ~ ~
~ ~ E ~ ~
~ ~ - 1 \ ~ . -r~
t~ '
,1`'~~z..~~ s ~ ~ - EACL% ~ ~ - ;
j ~ . . ~
. ~ 2~398 ;
?
. ~
FIlEO ANC aECOR0E0 .
S~.IUCtE COUMTAAS A' ~
R4G~F ~
CIEFti ~~r.~Ut~ COURt
ycc~c~~0
Pffr~~
- . Oct 18 ~ 25 PK'~3 t:
.
' • f
~
! I FURTHER CERTIFY that I wiil rcgister at my local address when the registration books reopcn, and
con~ply ~vith all other requirements of a le~al resident of tl~is State.
, .
I FURTHER CERTIFY that 1 l~ave no intention to return to my former dotnicile, and I intend to remain in
F
~
~ ; ~ ~ ~ ~ ~ S~ . Lucie , County,
~iorida, pcrmanently. -
~ ~ ~ ~ , i
` j,,, ~ QEA/r (tvsme) i
1~
~ \
' S G ~C .v~ ~ ~V.Z e_ . ' : i
, , . . . . ~ (Address) .
~ ,r Y • F
Swor~t'te~and~st~~~td~cfore me this ~ day af
- y .
" UH A.D. 19 73 . ~
; ' ~ : f
P ~ , , .AS,,~ CLERK CIRCUIT COURT .
- - - o R ~9 „~?JEiSi
; .~~~.k.~.._._....._ , ~ ` RUOK
4 - ~~r;r,,.. y
~ - - Deputy Cl:er
c~ .
. , ,
(Tu be eaecutcJ in Juptir~tr anJ unt~m.~l 1~k•d NiUr t'Irrk Ci~i uH ['uurl. anJ Ju~,l~.ate wilh 7'ax Asu•.~ur) _
. • ~
,
~1-'~ - tz
+K~ . . . _ _ , . -
v. _ . . ...w . ~