HomeMy WebLinkAbout1506 Deciar~~~ion ofi t~or~;~~;e u~~~ ~~~i~~.~~~E~~~~
~rii~. s~rn7~t, nr.ucouNl~Y ~~nx nss~:sso~t, 26'76$3
St.Lucie
_ CUUNTY, ~LURII)A: ~
"17~is is n~y drelaration of Domicilr. and Citizenship in lhc Statc uf rlorida that 1 am filing this ~lay in
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,~t ct~r~fai~cc, and in conformity with Scrtion 232.17, Fiori~ta Statutcs.
1~vas formcrly a Icgal n;sid~nt of , _ and I
CiIY) (Slale)
rr~idcd at ~ l;,L~~G ~ S~ o~~ r!~ ~'1 . However, I have changed my domicite to
- (Slcect snd Ivumber)
,fnd am and have bee~i a bona fide msidcnt of the Statc of Florida since l day of
now
- , 19-~.~, and 1/reside at ~ L ~~F ~1 0~' 0 l~ ~ Lf~ ~
~ ~ • (Stteet aod Numberj
~ , St Lucie Count;r, rtorida,
(c~~r)
~~~ld this statement is to be taken as my declaration of citizenship, actual legal residence and doitiicile in tlic State `
of Florida. •
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(Inseri here any pc~linent facts, such u sale oi property or business, or relinquishmcnt of employment at formcr
domicile, removal oi family to ne~v doroicile, purchue ot home, etc.)
Entering children in school: _
~ ~ ~'L L~";:~Y"'°z' _
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~ , FIlEO ANC~ P,ECOROED ~ ~
~ sT.iuci~ c~uNtY f~~_
~ RGGER PJi`RAS
CLERK CIRGUtT CQURT '
• ' RECOn' `lE~tF~Et1....~
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~ No~ 5 12 06 PM'73 ~
~ ~ 26`7683
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1 FURTHER CERTIFY that I will register at my local address when the registration books reopen, and ~
comply with all other requirements of a legal resident of ihis State.
I FURTHER C IFY that I liave no intention to reteirn to my former domicile, and I intend to remain in ~
S} . Lucie '
, County,
Florida, perntanently. . ~
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r,,' } ~ . (Nsme)
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f,'~i% . _z= _
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Sworr3,'~~n~~~~c~~d before me this ._.~day of
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~n:..,. -,e;~.}Fti ~ n.n. ~ ~?3 ,
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ROGCR POITRAS, CLERK CTRCUIT COURT . ~
. - - . . ~'oxK~~~ jar.EZJ~3 . .
_ _;~:~.;,~,...t., ~Y 1 y~ l Gt~
~ - . Dep~ity'~~~e
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(To be tsecuteJ in duplk~~e anJ utigiur lilrd wi~h (7rrk Circuil C~~url. anJ dupl~:~lr wilh T:~~ Asu~iur)
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