HomeMy WebLinkAbout0515 l~~c~~r~~f~n of ~c~r~i~~~~ ~izc~ ~sh~~~ ~
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7 c~ TIIE: S7'A'fh ANU CUUN1'Y TA\ ASSI:SSOIt.
S~.Lucie COUN7'Y, ~LORIUA: 2~~'30
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"Il~is is my dccl~ration of nomicilc and Gitizenslii~~ in thc Statc of i~lorida that 1 am filing this day in ;
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.~ccordancc, and in canfonnity with Scction 222. t 7, Florida Statutcs. • , , j
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I was farmerly ~ icbal residcnt of _ o ~ and 1
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rrsided at . However, I have changed my domicile to
- (Strcet and Numbet) ~
and am and havc becn a bona iidc residci~t of thc Statc of Florida since ~ day of !
now ~~,.5~ Gr~~~~e~-~ .~o~~ //,S~
, 19.~_., and I /reside at ;
(Sueet snd Number) r
~,Q j~ ~~,PC E St . Lucie County, rlorida,
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and this statement is to be taken as my dectaration of citizenship, actual legal residence and domicile in the State
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of Florida. ' `
(Insert here any prrlinrnt tscts, such u sale of property or business. or reli~quishment ot employment at former ,
domicile. removai oi family to new domicile~ purchase of home~ ete.)
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Entering children in school:~ Homestead Exemption; ~ f~
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I have been a re~ident of this C ounty for the past 16 ~
years . . - ~
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' fILEQ AMO RPC011DEQ ~ ~
• • S'f.IuCIE COUNT1r Fi~.
ROCER POttRAS ~ ~ : F
+ ' ~ - CLERK CifiCU1T C01?RT p
_ ~ ' RE~ORD VERtFiED . ~
- O~c t6 tl is ~N'~3 ~
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~ - ~ . ~ 2'71230
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1 FURTHER CERTIFY that I~viil register at my locai address when the registration books reopen, and •t
comply with ali otiier requirements of a lebal resident of this State.
I FURTHER CERTIi'Y that I have no intention to return to my former domicile, and I intend to remain in
p , C~~ C St' . Lucie County,
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~ Florida, permanently. «'`y~ • . ~ ~ 'i~
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(Name) <
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`.J`<• ~•~~~C,O~,~ , ~ w~~ ~„Q~ F
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~w,o~n.2~'i~td se~bs'c~c~ bcfor.~ me this day ot
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• ' MI. 1 . •
, .:'~•r' ~ A.D. 19 73 .
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R(Rl~f~'~I, .RAS, CI.ERK CIRCUIT. COURT '
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- - aQOK 22 ~~cE , ~15 . ~ ~
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(Tu bc ctecu~rd in duplicalr :u~J urigin.tl t~lyd ~ i l'Ir~{. Circuil Cuurl. and Jupliralo wilh '(ac Asus~ur)
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