HomeMy WebLinkAbout1826 Decia~ation of ~or~i~~;e ~n~ ~a~i~~.~~t?';~ zs~s~o
"l O "I't ll: S'fATti ANU COUN7'Y TA~ ASSI:SSOR,
St .Lucie
_ _ _ couN~~Y, ~LORI1)A:
TI?is is my d~claration of Don?icilc and Gitizcnship in lhc St:~tc of rlorida 11iat 1 am filing this day ii~ ~
~
accordance, an~ conformity with Scction 222.17, Florida Statutcs.
1 was forn~crly a Icgal residcnt of e~ e~~A tv , 5. C- , S• C• and I
(~r) (state)
r~ sided at 3 j 9 N~- Q~ Q S . However, i have changed my doriiicile to
t~eet and Number)
ancf am and have bcen a bona ~ fide residcnt of ti~c State oC Florida since ~?..i v 3!~l ~8 day of
now
l~/o v , 19~., and 1/~reside at ? 3 i3 Sa 3 G ~57R <<T
(Street and Number) .
~a ~ ~ ~~,e R. c , St. Lucie ~ounty, rlorida,
(c~~y~ .
and this statement is to be taken as my de~laration of citizenship, actual legal residence and domicile in the State
of Florida. ~ -
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment st tormer
domic~7e. temoval of family to ne~v domicile, purchue of home, etc.)
Entering children in school: .
j3Rv~~ ~2
~e x~ nr ~ ~ c 2 ~u ~ ~ 5 ~
.
~ Te~. ~ c ~ e. L ~ 8 ~e o ~ : ~ ~
- , ' - - ~ R o ~
P ~ y ~ , 5 ~ ~ zs~s~o
~ - / LEO ~4~ p:~ R EO
~ wc,~ ca:,~r~'r g~,~.
; . A~G( F ~ iRIS
` CI.C~'K Gt ~JtT ~OtlR1
~ 4Frr~- yr :,r~
e -
~ ~ _ ~ ~ 2~ aN ~73
~ ~
~ -
~ ~ .
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I FURTHER CERTIFY that I will re~ister at my local address when the registration books reopen, and ~
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend ta remain in
~ *
~ foR- T: ~ C~- ~ S. Lucie , County,
~lorida, pcrmanently. - '
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= ~ ;
= - " ~3.~-~-r,.~-- ~
~ ~ (t~.me)
i
_ i
~ - 23/3 ~ Sa 3~ 57", • ~
x
~ (Addreu)
V~ ,....~~~i~;lt~~l~
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T~ Sworn to and subScYjb~`cd.}~' i~jne this ~ day of ;
•~~auE~' A.D.19 73 . t
~ - . t: ~ . y . " ~
~ ROGCR :~~~,5~ ~~~K CIRCUIT COURT ~ • ~
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~ _ . . ~ - ~''!-y-~:~ ~..~3Y - QiC~ 3
~ . -~ePuty~7.er~
4 . . . , . :
(`I'~,b~e ~e~tcJfin Juplicatr anJ uri~•.i~~.~l tded w~~h t'Irrk Circui~ Coutl. ~nd Juplh~tr wilh Tax Assrcwr) _ ~
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