HomeMy WebLinkAbout1319 De~{~ra~:~on af ~Qrnicl~e a~d Ci~izenship
~~o -ri i~ s~~n~ru n~i~ c•ouN~~~' 'rA\ ASSESSUR,
st . ~,uc ~e 2Ei96~.~0
----------------COUnTY,fLUR1UA:
7~~is is my dcclaration ot Damicilc and Citiunship in the Statc of Florida that I am filing this day in
accordai~cc, and in confurmity ~vith Sertion 222.17, f=loricia Statutcs. .
t was forn~crly a lcgal residcnt of ~~~~Q~~ , z~ - and I
(citr) (slate)
residcd at ~~~~s~~~-'~ - . However, I have changed my domicile to
(Strret and Nunihrr)
and am and have becn a l~ona fidc resident of the State of Florida since day of
now ~ ~
- , 19---=- and 1 ~residc at G[~ ~ ~ ~ ~ ~
(Street snd Number)
: ~ . , St. LuCie County, Florida,
' (c~~r) -
and this statemcnt is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. •
(Inurf here any prrlinrnt facls, such as sale of prope~ty or busintss, or relinquishment of employment at fotmer
domicile. removal of family lo new domicilz, purchase of home, rte.)
Entering children in school:~ Homestead Exemption: ~
2696~~C1 .
FILEO AN~ RECOR~ED
ST.~UCIE COUNTY FIA.
R04iP. ~4~TRAS ~
CIERK C:hCU1T COURT
RfGOR4 vfR~~llO.~.~..~..~
4 O~c 3 10 ~e AM'T3
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~
I FURTHER CERTIFY that I~vill registcr at my local address when the registration books reopen, and
comply with all other requirements of a Iegal residcnt of this State.
~ I FURTtiER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
St . Lucie . , _ County, ~
~ ~ Ftor,ida; pzrm~nently. (c~~r) ~ ~
, - p . ~
. . . . . . . ~~,~i ~,G~t ~ .,,,1
- - -.~f~ 1.,
s~' - v (Name) J
^ . ~ ~ • - - ~~fiLt `
•C ~ <lis 1<~. ~ _
l - • , (Address) .
~ ~ • • , : '
~ Sworn t4~nd~subscribcd befor~ m~ thi; day of ~
, n ~
~ n _ n. ~ 7 3
~ -
ROGER POITRAS, CLERK CIRCUIT COURT
~ -
- - ~ B ~u~-t--G~c~
~ -
llepur_~? Cler_r;
•
(To hr c~ecuteJ w Ju~,licalr :u.:l „n~au.J f~Or~i ~~ith l'Irr4. (irauil (~nu~t.:~ud J~q~h:ale ~~ilh T.~Y r\csesw~t) .
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