HomeMy WebLinkAbout0382 ~~V44 ~ C.~tt~L.`~ ~i 1.1~~~~it ii~..~.~~~i G.4~ i~w ~i~~~~.l:i 1Ji ti=./
2'71129
~ru •r~ u: s•rn•r~: n~.l~ c~un'1'Y •rnx nssrssoii,
St.Lucie .
_ _ CUUI~'1'Y, I~ LOitl1)A: ~
Tliis is my drelar:itic~~~ af 1)amirilc and Citizcnship in thc Statc of rl~rida that 1 ant lilii~g ihis day in
arrordanrc, and in confonnity ~vith Scctio~~ 222.17, l~lorid,i Statutcs. • ,
I was formcrly a lcg:~l residcnl t~t --~Q~ ~7'-~ ~t1 . ,~AS SAc_ ~ uscf ~S and I
/ (c~~r) (stsce)
resided at ~!~04- . However, I have changed my domici[e to
(Strect and Number) ~ :
9 :
and am and have been a bon~i fide rrsid~nt of the State oC Florida since ~ day of ;
` now
_ ~U / y - , 19 7Z., and 1 /fresidc at ~3~~~T-Q' ~v~
(Slrect and Numbcr) i ~
vC i~~ . S~ . Lucie County, I'lorida, .
(c~~r) '
a?~d this statement is to be taken as my declaration of citizensl~ip, actual legal residence and domicile in the State
of Florida. .
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(Insert here any pertinent facts, such as sale ot p~operty er Dusincss, or ~eli~quishment oi employment st tormet
domicile. romoval of family tu neN domicile, purchase of home, ete.)
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Entering children in school:~ Homestead Exemption; L--J ~
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S~~IUCIC COUNTY ~LA. ~
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CLE~K Ct:~CU~t COURT .
" pECOR VfF:''~EO...~.~.
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I FURTHER CERTJFY that 1~vill register at my locai address when the registration books reopen, and
comply with all other requiremenis of a le~al resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domicile, and T intend to remain in
~ ~ - St- . Lucie
D JZ7" ~UC y , County, ~
~ Tlorida, permanently. cc'`y~ ~ ~k'
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i ^ (Name)
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S~vor~qf'to.a ~ subscribc~ 6cfor mc this day of
_ n. n. 1 ~____7 3 ~ :
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ROGER" POITItAS, _CI.ERK CIRCUIT. COUItT
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(1'o (x' tar~utcJ in Ju~,li~:ih• anJ u~i~ in.~l (d~•d v.~N~ 1'Irtl ~'~rcuil C~~url. a~~d dupliartr Kilh '!r~ A~S~•ctior)
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