HomeMy WebLinkAbout1181 . ~
C~~~~~r~:~:~~n ~fi ~i~~, ~ Gy~iz~~~hip
- 2~zss3
"f() TIiG S7'A1'l: ANU (:OUN'I'Y "fAX ASSL•:SSOIt,
S~.Lucie COUNTY, I~l.ORlDA:
71?is is my dcclaration ol' Domicilc and Citircnship in thc State of Fiorida ti~at 1 am filing this ~lay in
accardancc, and in conformity with Scction 222.17, Florid~t Statutcs. '
z
:
1 w~~.e formcrly a icgai resident of ~~E ~"L, /3~'T t/ ,~'R c and I i
~ (Cltr) (state) '
residcd at 7s'~- /~~~z~ rv i~l_v_~. ' . However, I have changed my domicile to !
(Streot and Numhatj i
1
a~id am and have becn a bona ~dc residc,~t of the State of Florida since ~ z-o day of
now
T~=mR ~.2 , 19? 3, and I/Fcside at Z~S a s v~ L t
(Street snd Number) ~
no~~ g~r. L, u~.,,: St. Lucie _ County, Florida,
(r~~y~ - .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Florida. ~
(Insert here any pertine~t-facts, such ss sale of property or business, w relinquishment of employment st totmer
domic~le. removal of family to new domicile, pur~hase of home, ete.)
! Gt~LGH~i S~f /Li~~J.~r~E ~FT~ -
~ ~
i
t
~
~En~ering children.in school:~ Homestead Exemption: ;
k
. i
i
~
ST~WC~f COUNTY f~A. ~
ROCER PO1TttAS G ~ _
CIERK Ct~CUiT COURT i
RECORO VfR1fiE0~~ ~ '
~11 Z ~ ~ 0? ~'7~
2'71663
t FURTHER CERTIFY that t will registcr at my local address when the registration books reopen, and
comply with all other requirements of a legal resid~nt of this State.
I FURTHER CERTIFY that I havc no intention to return to my forn~er domicile, and I intend to remain in
T ~'7_ r St . Lucie County, '
Ftorida, permanently. ~~''r~ ' ~ ~ ~
_ _ `
(Name)
- - 7_,~._.~ 8>,er~~D I3LG.c~ f'•n ~i' L~ i.i
v`.r : 4'0.,,~,,I ` (Address)
; V G ~
S~?pc~i.~c1~~psC}j,~~(~ VC~OfC i11C II11S -_~(I1~/ Of {
tJ y. ~ G: r. ~
.t ,
w g~ = " A. D. t 9_Z4.~ r .
_ ~ . _ ,
.
: ~I~QGB~°~ .TRl~, CLE CIRCUIT COliRT
t-''y.' A , L` •
.,.r
~r<~~
~ ~~`.s._ d0~ac~~r~ PACE1~~i
'~•,•.,.~~~~.~~f~;-- _ _ 5,,,,
. I3-eputy
~rer
(To br e~ecuteJ in duplicat~ eoJ oritimal fdri ilh Clerk ('ircuit Cuurl. and dupli.ate with Tax ~?ssessor)
~ - . ~
~ ~ - -
~ 4~~ , - - ~
_ - ~ ~.,.r_.