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268920
Dect~ration of Dar~g~cii~ ana~ C~t~:~ ~n~~i~::~
~~o •rti~: sTnTi~ nnu c•ou~~~~~ •rnx nssi~:ssoit,
St.Lucie
_ CUUN"l~Y, 1~LOl:I!)A:
'fl~is is n~y dcclaratioi~ of Domicilr an~1 Citiirnship in lh~• Stat~: of ~Ic~rida that I am iiling this day iii
accordanc~. and in conformity with Section ~??.17, t~loricla Statutrs.
1 w~s form~rly a lrgal resiJrnt of __~~T7~ U/t JV Ca __y a~~~ ~
(City) (StatC)
residrd at _ ct~ : _i X U(~__ , However, I have clianged my ciomicile tu
- (Street and Nu~nbrr)
and am and havc bccn a- bona fidr rrsidcnt of thc Statc oC t=lorida sincc ~ ~ day ot'
now
C- T
i ~ ~ , 19 ~ and 1 /~-esidc at _____S____~~_v_~Y ~ t_
(Siteet and Number)
+ F V_ r F , St. Lucie ~ County, Florida,
(c~~r)
and this statement is to be t~~ken as my dcclar~~tion of citizcnship, actual legal residerTCe and domicile in the State
of Fiotida.
(lnserl hrre any prrtineM facts, such as salc of praprrty or businrss, or relinyuishment of rmployment at formet
domicile, removal of family to new domicilr, purchase of home, ctc.)
Entering children in school:~ Homestead Exemption: ~
~e~bp~-~ }~iL ~c~~e ~
2~,920
~ FllEO 1?ND RECORDEO
St.111C1E COUNTY fLA. ~
- RQCER PQt7RAS
CLERK CIRCUI7 COURT
_ RECOR~J V~Ai~1~D...~--
NOV 2~ ~0 20
-
I FURTHER CERTIFY that I will registcr at my local address when the rcgistration books reopcn, and
comply with all other requirements of a legal resident of this State.
I FURTNER CERTIFY that I havc no intention to return to my fornier domicile, and I intend to remain in
~ 1 ~ J~~ ~v~?~ _ St. Lucie
, County,
Florida, pcrmanently. ~~`~Y~ i .ebc 2 ~ ' ~
L GvKr"
. ~ ~ ~ , ' ?
ame) ~
~ ~
,.e:...... , _ y ~Addreu) T'.r n P -
h v lTr yc~~ ~L ~
Sworp ~to,a~~~p~+u~-~ib~c1, bcfore inc thi~ _ d;~y af
--==-}i A.I). 19__. 73
:RO~ER 'POITRAS~~ ~CLERK CIRCUIT COURT
. : . - - a ox2~'i ~A~t 34J
_ _
• Sl -~y U~ruty 1~
(To bt c~rcul~,1 in Ju~~Gc.~f~- :~nd nn;•m d(~Ird ~~~ib l"frrk ( uc~~it ("~.i~rl.:m~l Ju~~(I~JI~' ~UIII ~J~ A~.~ ~.~~~r)