HomeMy WebLinkAbout2115 R~~lu~'c:~~a~ af ~~i~:;L,:~~ ~.:~t~ ~:~tZ~:~::~i~:' ~
ru ~r~i~ srn~r~: nnu cuv~~~ ~t~nx nsst~.s~c~it. 2'72360
S t . l.uc ie
- ('OUN'1'1', 1=1.OItIDA:
Zl~is is nty dcrlaration of 1)on~icilc ancf ('itii~nshi~~ in thr St:+tr of I~lorida tliat I ant f~ling thi, ~lay in
:,crordancc, and in canformit~~ with Srcticm'2~.17, 1~lori~la Statutrs.
1 was formcrly a Ir~:~l rrsi~lrnt of ---~Q_Y'~_-tJ ~~o~----- u' and 1
/1~ (CilYI (Slatr)
rrsidrd at ~~~_h'? d~~ _ t? • flowcvcr, 1 havc changcd nty domiril~ to
- (Slrr~t anJ N~nnbcr)
ancl ain and havc bc~n a bona ficle retiiclcnt of thc Statc of Florida sincc .o f ~ Z day ot'
now
, ~~_?3 , ~~,a i ~~~.~a~ ~t __3_~t__!U__E ~Q-1''~l~e - l~r
i--- (St~eet and Nu~ bet)
_Sfi~L~.c..~~------ T , St. Lucie
. - County, [=1c~rida,
(c~~r)
and this statement is to Ur taken as my declaration of citizenship, actuai legal residence and domicile in thr St.fte
of Florida.
(Inseri hrre any perlinrnt facls, such as salr of proper~y or businrss, or rrl7nyuishmrnt ot employment at former
domicile, rrmoval ut family to nc~~~ domicilr, porchaxe ui h~~mr, rtc J s
f
~
Entering children in school:~ Homestead Exemption: ~ 3
~
t
;
fP,iL~D aAitU ~tEL'DA~ f
I .
$1[.~L'U~IE CDitil'i'M'FLM. ~
j iRUir~ p~l'~~
' !C.L'fftl~ Ctl-GWT ~OlN~T
~ ~ R'~~~JFp YE"1 ~;p
_
. il~ ~ 21 ~1'~~ ~
2`~23so
i
' F
c
I FURTHL'it CERTIFI~' that I witl rr~ister at my local address when the registration books reopen, and '
comply with ail other requirerne~tts of a Icga! re~idcnt of this $tate. "
1 FURTHER CERTIFY that 1 havc no intcntion to rcturn to my fornicr domicilc, and 1 intcnd to rcmain i~i
~o S~' l~ L St . Lucie , CountY,
F~lorida, permanrntly. (c:'~y~ :
. ;
. ' ~ ~ . ~
; ~ ,
. "'•~.,u~~' (IVame) .
'
J-.~ ~~~,'l S%.~';
~i.' ~ ~ _ ~ ~
r~.i7~:. . ~ ~ y= i -`.C~Iam~- t
~ 'b , . ~
~ ~C?~~SPI ~
Sworr~`~~and subsc.r~~~beforc mr this ~ay of 1Tit~g a ress~
'';l~~i•;• •
~ - A.n. ~~)-74_.
ROGLR ~ TftAS , CLE~i~ C I RCU IT COURT
- - ~
' _ _.~r...~ ~Y~X ~tirN j-,i~~ ~
" _n ~ c ~
y- Deputy~e
(T~~ bc caecui~•~t in d~,~ii.:~~.• :~„~i nri~•in.d 1` I~~~tl~ (lrrA Circuit Cuurl, :~nJ dupG~ a~c wtill~ Ta~ Asx~cnr)
i
, ~ . :