HomeMy WebLinkAbout2827 e,. • . ~ ^ ~ ~
~E.'C~7i
c~c.EQtZ Q~~ ~E3i`c:~~i:~ c~~~.,.. ~~~IL:t..~:~..;~ t.;,
<<~ STATt: ,~r.~~~ c'OUN~TY "t'AX ~1SSl~ SSOR, 2~~3,7
St.Lucie
- - ._T._ COUNTY, 1~ LORIUA: '
TI?is is my dccl:?ratiun of namicilc and Citizcnshi~~ in lltc Statc of Florida th.~t I am filing this ~I:~y in ~
ac;orJa~~cc, and in conformity ~vith Srctio~i ~22.17, Ftori~l:~ Statutcs. ~
~ ~~~o~ ~1
t was tormcrly a Icgai resid~nt of , -and 1
~ - (citr) (state)
r~~,ided at ~y' g . Howcver, I have ch nged my domicile to
- (Slrcrt and Numtxr)
asicl am and harc becn a Uona Cdc residcnt of thc Statc of T'lorida since day o1~
now D L~~ D~c r 1~
_ , 19______.__, and 1 /rc~idc at
/ (Stroet and Number)
~T_ p~~ . S~. Lucie County, rlorida,
(c~~r)
.~nd ihis statement is to be taken as my dcclaration of citizriiship, actu:~l legal residence and domicile in the State
of C'lorida. . ' ;
(Inseri here any prrtinent facts, such as sale of pn~perty or busin~u, or relinquishmrnt of employment af former `
domicile, remo~•al oi family to ne~v domicile, purchase of home, rte.) ~
~
~
~
~
t
Entering children in school: '
. ~
~
fILEO qML F ~
SL ~UCEf CoUklr ~E~ :
~ ~ ROCEa ~ , S
lA, ~ '
. PF ~~4nFY?'C~~t+F U,T ~Q~RT ~
_ ~
J ~CT ~
it !p D3 Ay ,r3
~
~ 2~53 ~ i
~ ~ ~ _ .
: . ~
. .
~
i
t
f .
~ • ,
E '
! {
~ ~ - {
' I FURTHER CERTIFY that I~vili register at my lor+l address when the registration books reopen, and
g comply with alI othcr requirements of a Iegal resident of tltis State.
? FURT • R CERTIFY that I liave no intention to rcturn to my former domicile, and I intend to remain in
~ . ' S~ . Lucie , County, ~
~ l~lorida, pcrmancntly. - ( ~t/y/l.'~y }
; v
~ . 1 ~
~
;
; . . f, . , ~ io . ~
cnaa«~:,
' r.
Sw=or~t-ta and su~ic~l~d befoic me this ~ day of
~ : s . _ t ~
~cct-: n. n. ~ 7
3 , . ~
r . ~ ~
. ,~~/~J~/'~)~:~ R••P ~ ~AS, CLERK CIRCUIT COURT . t
~~j~ . ~ ~
' i S - i R a ~ . _
~:f~~~ •
N~~~1~~~
i • ~ ~ ~r • 1~
: _ - - BY ~ t~c~ BO~O+c ~19 ~AG~ ~~~V
~ . . _ ~~epu~y ~l.c k
. ,
- (To be executrJ in Juplirate auJ u~igm.~l .•d ..1U~ l'I~~~~. Circui~ e'~~urt. auJ Juph.rlr ~vith 'I:~~ Asscsw~) ~
t
F~
, ; '