HomeMy WebLinkAbout1459 t~~~«~~~~an o~ ~ar~~;~~~~ u~~ ~:ri~~:~r~~~~~~i~ ~f ~
rc~ ~riic s-rn7~r n~n c~~un~~t~Y "t'A\ ASSfSSOiZ, 26`7652 ~
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_ ____~__~~_._CUUNTY, !°LOIZIUA: ; i
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"Iliis ix r»y dccl.uatiun ot Damicilc and Citizensl~ip in thc St:it~ of florida that 1 am filinp; ii~~s ;lay in ~
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a~rc~nlancc, an~l in cot~Cormily with Srction ~22.17, rlori~ia Statutcs.
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1 was fotmcrly a ir~al residcnt ot _~T ~
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~u~ To ~u , V1Q~ ~ A _ and t
(Cityj (State)
mtiidcd at ~ ~o X. y7 Hawcvcr, I havc changcd my domicile to
- (Strcrt and Numbrr)
anci am and have been a bona fide re~ident. of the State of rlorida since day of
now
_ ~ C7-oB~~ - , 19 7 3 , and 1 /fresicic at _~G 'l _ S . /5~ ~ ~T' ,
(St~eet and Number) - 3
FT- I~,E~et~ St. Lucie County, Florida,
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(citr) •
c~nd this statement is to be taken as my declaration of citizenship, actual Iegal residence and domicile in the State
of i~lorida. -
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(Inscrt herc any pertinrnt facts, such as sale of pr~pc~~y or busincss, or rclinquishment of employmcnt at former
domicile, remo.al ot family to new domicile, purchax ot home, etc.) t:
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Entering chiZdren in school:
CHARLES E t7wARll NAWX ~~/S •
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- f ~EO ~N: RkCpR0E0 ~ ~
3~- UC~E C4UitT~f FLA„ :
. . ~OCES ?~1'R~~i ~ -
~ CtfRK ,,;'.r,~;r ~OtfRT ~ i
_ , °F^~Rn :f~.•ftEO ~
~ ~br ~ 9 i~ AM '13
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I FU~T~iER CERTIFY tl~at I~vill rcgister at my local address when the registration books reopen, and
com~ly with all other rcquirements of a legal residcnt of this State.
I FURTHER CERTIFY that I l~ave no intention to return to my former domicile, and I iniend to rcmain in ~i
~r-. /~,E',ec~ S~. Lucie County,
Ftorida, pcrmanently. ~~''r~ . . ~
. ~ ~~c--1~ ~V i ;
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(Name) ~
A ~
" ~o ? T_ / 5~ .7~ ,c-~ ~ ,Q~ .
(waare::) 3;
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S~vvrr~,tp :3~1:d~b.~tr~brd'tiCfore me this -`5 day of
r_ . , . .
' . ` . ~ ':~~1(~. A. D. 19`7
3
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~ -'KO~E,R POYTR~;; .~_CLERK CIRCUIT COURT ~ _
:v:~= - - ° 220 ~~~~1456
~ ~ ~ ~ ~ ` _ . aooK _
~~n;!,,:. . eP~'y Clerk
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(To be executeJ in Juplicalc aoJ UfIf1I1JI II~~II N'II~I (~ICt~: C~If("I~II CAtlfI. and dupG~~ir ~~itb 7"ax Asseswr) ~
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