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Decl~:~atia~ of ~orr~~iie ~:nd ~iti~::n~i~~~ '
;
TU THt: ST/lT~ ANU CUUNTY 7~AX ASSt=.SS(~It,
St.Lucie
COUN"1'l'. [~1_U~:!!)A:
Tliis is my dcclaratic~n of Uom;~•~I~. an~t ('itirrn•hi~~ i~~ th~: Statr oi' l~larida tl~at 1 am liling this ~lay i~~
accor~la+~cc, and iu ~onformity with Scrtiori I Florida Statutc~. - .
1~vas formerly a Icgal resident of C~~[ Cd~~. _ and t
(('itr) (state) i
n:sided at CN~P~~ _/Yi~c Ro, Howevcr, t have changcd my domicile to
(Street and Number)
and am and have betn a bona tidr rrsident of the State of Florida since i day ot'
now
_ , 19__ , and 1/~esicle at 3/O/ P~c~~ TT I~D .
(St~eet and Number)
Po~ T,S'T. c. u c. ~ . St . Lucie County, Florida,
{c~~r)
and this statement is to be t~kcn as rny declaration of citizenship, actual legal residcnc~ and domicite in tht State
of Florida.
(ir~seri here any prrtinrnt tacts, such as salr of pruperty or business, or relinquishment of employment at former
dom.ic~7e, temovai o( family to neH• domicitr, purchasr of home, ete.)
~ r~ Or r
J fN/ T•~-F F~ O/'j / l~.9 P~ c~ ,f*?D G~ G k~-
Entering children in school; ~ Homestead Exemption: ~
L ~S~ ~''I./~3~•f.e/ v./!.'~ s
d~,~/ Eci~R6Fr,•. DAVis t
~oi~.t/ Qc{.?c ~f*~ D~Yi J
Fi~a ~
stRt~ ~~~ca~~ ~
RE~ DRYFR cC
~r CQUJtj ~
. ~
~ 9 41 ~'j~
26;8~1 .
l FURTHI:It CERTIFY that ! will register at my local address when the registration books reopen, and
comply with all othrr requircmenis of a legal resi~ent of this State.
I FURTHI:R CCRTI~Y that i havc no intention to return to my fomier domicile, and 1 intend to remain in
St . Lucie County,
Ftorida, pcrmanently. (c~'y~~-_---------~ - q, a/Q ~
. ~ 5 y/ )
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S.vx6~n.to~and t~b~c,~y~becl ~bcforr mc tl?i; day c~f
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/ ~~--~-~-~-fr4--'_y~~~?1_?~~_, A.l). 1 73 _ ~
RO~~R"I~~OITRAS, CI.F;RK CIRCUIT CUURT
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(To t~c eaeculrJ in du~~h:.il~• :wJ ~~n}~ fd:J ~~~Ih ~ Irrt. ('ircuit ('.~url. ani! du~~l+ra~r a~lh 7ax Acu•cs~.t)