HomeMy WebLinkAbout0534 D~ct~~
atias~ of Dorra~cile and Citiz~ns~~p
~
'fo Tfi~, s~ nTr: nni~ cov~~~'Y "l~t~~ ASSI:SSUR, '
St.Lucie
cou~~cY, t-~o~~„~~: 259050 . ;
T~is is my drelaratiun of l)umirilc and Citiz~•n.l?ip in th~ Slat~ of t~lorida that I am liiing this day in ;
~
accord~iicc. and in conforn~ity with Scrtion '_32.17, Florida Stat~~tcs. . ;
1 was formrrly a 1~ ?al r~~'dcnt of' ~j j~ LU e , and 1
_ ~a ~1'~ S-! r ~ tc;~y~
resided at . f ~ However, j j~ave chang~ei n~y ~iu~i~icii~ t~
(Sttret and Numbrt)
and am and haye bc~ n~~ bona fide resident af the State of f•'lorida since y` '~9d~ of
1 now
_ ~2 ~ e~'"'~ D F' i' , 19~_~ , and 1/fresidc at S~ a ~J 7~ r~
(Stteet and Num~et)
1- u C/~ . St . LuG ie County, Florida,
(c~~y)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. -
{Inser( Aere any perlinrnt facts, such as salr of property w business, or relinquishment of employmenl at tormet
domiede, removal ot (amily to new• domicile, pucchue of home, ete.)
Entering children in .school; 3~ Homesteac~ Exemption: ~
/{~a~ r n S~ L~.~vf ifif 2 r- ~ .
~ Ic-1i•~ a- ~ M yl r'ir-~
~ ~ PY~
~Q r r FILED AMO RECORD!
~ 3T_ LUCIE COUNTY F~~
ClE K~tIKCUjT COUlIt ~
RECQRO YfP.~F1f0.~~
Nor 13 10 zo AM'73 ;
2fi9Q~0 '
;
~ .
~ -
~
; I FURTHER CERTIFI' that t w~i!! registcr at my local address when the registration books rcopen, and ~
~ comply with all oiher requirements of a legal resident of this State. `
t :
' 1 FURTNER CERTIFY that I havc no intcntion to return to my former domicile, and.l intend to remain in
o- ~ r f s'~ ~ u ~ ~t. Lucie
~ County,
: Florida, permanently. ~~'`y~ ' ~
~ (Namt)
_ - l /O w ~ ~
` l ! :~'~-•1~~- (Address) • ~
r. ~ :
-Sworri~q,at~,tilc~~~'~ed Ucfore m~ tl~is 3-- day of ~
; ' _ - >
y ~ z= ! .
= • `~;t~,~ A.U. 19-73--
~ , °r =
' ~'f~bG$Rl`~ AS CLERK CIRCUIT COURT
; ~ ~ '
_ ..:.~-~o.,.:.~~ - - ~i ? 'r~
" ' ~y - ~l c, ~t oO~X i'4GE~ ~ .
; - c:~~uty Cl erk-
(To be rarculcd iu dupl~:.:~r and uri~:m.~l fda•d ~v~lh ('tr~{, Citcu~~ ('~~urt. JOI~ ~IU~~IICJI! N~fti Taa Attr.~ur)
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