HomeMy WebLinkAbout0841 Dec4~~~at~~~ ~c~3 t~ici?~ ar~~ Ci~iz+~n~h~p
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TO 7'til: STATI: ANU CUUNTI' "TA\ ASSI~ tiSOR, :
st.Luc~.e 2~1445 ~ ' -
---__'COUN"fY, FLOt21DA: ,
11~is is my dccl:ir:iiion of Domiciic and Citiz~nship in thc Statc of Fforida that 1 am filin~ this day in
accorclance, and iti confonttity wetlf Sectic~i~ ?~2.17, Rlorida Statutcs. . ,
~~y~ ro~~y a i~~;~i T~S;a~ ~~c or __~~.cL+tl - ol e2n8Sa, and 1
~c~~y~ ~~~e~~
resided at 1~~,~~ i
rQ~oc~________ . However, 1 have changed my domicile to
(Street and Numbrr)
and am and have been a bona fide rrsident of the State of Florida since ~ . day of
now ~
~ac~--- , 19Z~ and 1 ~residr :~i .S` l~,. E.y,a.~t.
(Street and Number)
~ 33,~~,~ St. Lucie
~~~~y~ - . - County, Florida,
and this statement is to be taken as my declaration of citizenship, aetual legal residence and domicile in the State
of Florida.
(insert here any prrlinent facls, such as s:~lr of property or business, or ~elinquishmenl of empioyment at former
domicile~ temoval of family to new domicilr, purch~x of home, rlc.)
Entering children in school:~ Homestead Exemption: L11
. _ ~ad~
~
.
F~~EO ~?Na RFCOR E
~ , st ~uc~~ cauNTr
ROCER ?O~TitAS ~
CIERK CI"~WT COURT
P,fCBR.D YEp~F~EO
OEC 18 ii 4i AM'~3
2`71445 .
1 FURTHER CERTIFY that I will re~ister at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that t havc no tntention to return to my former domicile, and I intend to remain in
f ~ St . Lucie , County,
~ Florida, pern~anently. (c''Y~ ~ ~
./~n~+ ~ E/
t- : _ (Name) ~ C //4~
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Sv?ro~;to ahd sub~cntici~ befor~ mr thi~_ d.~y of
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~ ~ ' ~ - A_Ti. t ~____7_3
~.,$DG~R-:.RF11~~1S, CI.~RK CIRCUIT COUP.T
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