HomeMy WebLinkAbout2693 . _ I ,
~~c~~r~~E~n c~~~ E~r~~t~~~~ ~~~~~~;~~h~~
~ro -~'liP STATC: nNU cc~uN~~~~ -~~nx nssi-ssoii, 2'7Q658
St.Lucie
COUN'1'Y, 1~ LOlti!)A:
Tl~is is n~y dc.claration of Donlicilc and Citir.~nship in thc Statc ~f ~lorida that I am filing this day in
accordancc, and in confannity ~~~itli Scction 222.17, I~lorid.i Statutcs. • , .
• Ei
1 was fonncrly a Icg.il residcnt of ~ S Y , ld~~ ~ and I
(c~~r) (sa~e)
resided at However, 1 have changed my domicile ta
(Strect and N ber)
and am and have been a bona fide resident of thc Statc of Fiorida since ~ day of
now e ~
19~y and 1/~residc at i~
~ (Strec! and Number)
, ~~,o . St. Lucie County, Fforida, ;
(~iy) ~
and this statement is to Ue taken as my deciaration of citizens?~ip, actual legal residence and domicile in the State €
of E=lorida. .
(Insert here any pertinent facts, such as sale of property or busincss, or relioquishment of employment at tormet
domicile, removai of family to new domicile. purchase ot home, etc.)
[
~
- , ~
r
Entering childre~ in school:~ Homestead Exemption: ~ '
~ ~ 2'70658 ~ -
_ r
~ - f1~E0 AN~ RE ORDEO '
ST. WCIE COU~TV FLA.
RdCEFi r"OtTRAS
~ CLER~ C?~CUcT COURT '
RECOR~J `lEii!~iEO......~...~ ~
. ~c i l .1 a9 PM'7 ~ -
- - . - . .
- .
; . ,
~ . .
1 FURTHER CERTIFY that I~vill register at my local address when the registration books reopen, and
~ comply with all other reqi~iremcnts of a leaal residci~t of this State. ~
f
~ +
I FURTHER CERTIFY that I llave no inte,~tion to return to my former domicile, and I intend to remain in •
~ St . Lucie , County,
` ~ Florida, permanently. ~ ~
. ~~!CJI - ~ ~/y~1-~rR.I
(Nsme)
~
~ `
; ~..~t~~?~~??.h~i ~ T_ f
: ,t: -V ~:r~AdJress) .
i S~~orn to and subscribcd b~tor~. mc this ~ dc~ of U r
~ y ' r-? ~ _ • ` ,
i (/`~...I~YL4%~-C/(/ ~ 3 : . , t'~ U' ~
A.D.19--- • - ~ <
' ~ - . ~
; ROGER POITRAS, CLERK CIRCUIT. COURT ' S~ ' . - , ~ ~
• • .,,c'l~~ ~ ,
~ _ _r... . , . ~~c~~~ , ' ' .
~ - -~y-- y)CpUt.}' -~~.C`1"~: ~ ~ ~
~
~
(To bc cacculril i~~ du~~lia'~?r auJ nti~t~n.4 Idr.l ~ull~ (~Ir~i ('itruit (O~~l.:~~ ~~it,
:~~1.~ ~v~' a~ A~~citu~) ~
8 ~