HomeMy WebLinkAbout1811 ~~~.:Ci~'" ~a~'.~: i ~t _ .,a;~i ~ c:.~~i i.~ ~„r~L~..:~n:1e ~
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I U Tl U: STAT1: nND CUl?i~ TY "I~.~\ AS~I ~SUR,
st . ~.uc ~e = _ , 2~'210`7
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"(liis is my dreiar:itiui~ of !)c~~i~icilc a~u! Citiz~•+~st~i~~ in tl~c Statr c~t~ [~lorida Il~ai 1 am filing this d:~y i» ;
:~crurcl:u~cc, and iu ca»formit~~ with lrction ~"~'.17, l~larida Statutrs. ~
1 was formcrly a lc~::+l resiclcnt o1~ -,L~'~`i:~-_C~ - . , • ` and 1
~ (CiIY) ( atr) ^ ,
msidcd at • How•cvcr, 1 h:+vc changcd my domicilc to
(Streel and~umbrr)
and am and have bern a bon:+ fide nside~~t of the Stat~ uf I~lorida since ~~s~~.-- - day of
now ~
- - - , 19~.__, and I /~reside at --~--s_d~? _
~ ~ (Streel and Numhet)
jL y~,~,s: St . Luc ie _ _ County, Flarida,
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and this statement is to be taken as my declaration of citizenship, actual Ie~ai residence and d~tticile in thc State
of Florida. -
(Insrri Aere any ~+artinent factc, such as s:~tr u[ property or busin:u, or relinqui.hment of cmployment al former
domicile. t~mova! ot tamily to nc~v dumicik, purchase o( home, Ne.)
Enterin children in school:~ • ~ '
g Homestead Exemption.
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c1~Ax c~~ca,T co~r
RECCRO YEPtF1E~
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I FUKTHFR CERTIFY that I will re~;ister at my loc:al address wl~en the rcaistration books rcopen, and
' comply with all other requirements of a legal msident of this Staie.
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I FURTHER CERTlFY that ! l~ave no intention to return to my tormer domicile, and 1 intend to remain in
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; .~1~7`2~~~ , St . Lucie , CountY,
I Florida, permanently.
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~:~G~?,; . ( me) -
, ; `'~a » _ : s . ame _
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~ Swor?i~~o;~nd subsc~i~d bcforc mc this ~ day of
~ ' . : k,;
~ , i ing_",c ress
_ ~,~,f`c ~ i~~ p.n. t 9~74__. l'.,,~~_
= ROGE~I~~'~ TRAS , CLE K C I RCU IT COURT
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: - Ily , ~-1 _ ~'~'14 ,
` - eputy C1
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(To be execWeJ in du{~li: atc :ued uri~c~n.~ ( IeJ ~:ilh ~'Ierk ('ircuil Coutt. and JuplKale w~Ih Tax Asuccot)
~~~x 222 P~E 1~i~1
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