HomeMy WebLinkAbout1214 '
t~^~i~~~tia~~ c~f ~~?r~~~~l~ ~:~d ~i#~~~~~si~:~?
~ c~ ~~il; S1'ATI: ANU COUN1•v ~•nx nss~:sso~i, ~ ,`,'~~693
St .Lucie _ _ ~•UUN"1'Y, f~ LORIDA:
'fltis is my dcclaration ot' Uotnicilc anci Citizrnship in thc Statc of f
lorid~ that ! ant filing Ihis day in
:~~cordancc, and in coi~formity with S~~ction 2?~.I ~i, Florida Statutc~s.
1 was formerly a Icgat residcnt of , and I ~
~ Y) tste)
r~sidcd at ~ 33 ' .}iowever, I have changed my domicile to
(Street Numberj
~~nd am and have been a bona fidc nsident of the State of Florida since day of
C~ %~7 ' ?lOW ~ ~ `""T r '
19 3 an I/reside at ~y
' ~ ~ ~ ~ _ (Street and Number) -
• St. Lucie County, Florida, ~
~ (C~~y) ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
~
of Florida. ;
(I~sert here any pertinent facts. such as mie of p~operty or busi~ess, or reli~quishment ot employment at tormer `
domieite. remora! ot tamilq to ne~v domicile, pu~chase of Aome. etc,)
.Entering children in school: ~ Homestead Exemption: ~---.1
~
a~o REC~~~i.~?-
F ~E~C1E COUN L~ ?
S~• aOGER POttR~?s ,
C4ERK CIAC E~Q COURS ~
~ IIEC~RD ~E~ F :
t 3 ~eK~~~ ~ ~
~
~ ;
~ 2~~.693 ~
I FURTHER CERTIFY that I~vill register at my local address when the registration books reopen, and ;
comply with all other requirements of a lebal resident of this State.
I FURTHER CERTIFY that 1 Iiave o intention to rrturn to my forn~er domicile, and I intend ta remain in
. 4,~~~ ~ St . Lucie
~c;~r~ ' , County,
Florida, permanentty.
~ .
t _
. ,:-:2''~_+~
~~~..~~:.~.r~~,~ - ~
~ •
{;U~ ~ . n f,~~ ~ (Name) ~ ~ :
~ , ~ f
~yv~. ~'~,r~~. . .
r • ' ~ti', -
; ~ , rr;;` . ` (Ad~
)
; ` i a- ~ . , ~ ~ ~ ~ -F ~~`-`~-r ~
i; ' t~. O ~ I
F~wiUrzt.t~an~ ~ub~scrlb~cl fore tnc this _.s~-__ day oi ~
~ s i c.'
_ , A. D. I 9 __z~.
~
''R ,,~~T~S, RK CIRCUIT COURT
',...-;.w~~' _
_ _ ° R 222 F~~~2~~4
_ -I;X- e~
t-r C r U 6GOK
~ Y
x
(Tu bc c~rcuhd in plicrtc .~~~d origin.il filyd ~ ith l'trrk Cit~uit Caurl, anJ Juplicat~ with lax Asscss~r)
't
. s
' _ _ . _ - , ;
_
_ s~- ~r
~ 4 ~ ~ ~ _ _ _ _ , - ~