HomeMy WebLinkAbout2250 :...~~.I~/':..:•E.i~l~..~a~ ~t a./~b'~ :',~~1~i Li11~~ \/~~e~\r~~i~lCp
2'~2450
f U~1'lll: S'fA~l~i: Ant) ('t~11N7~Y '1,~\ ASSl.SSOlt,
St.Lucie
_ _ GUUt~~I'Y, T=Lt)itiDA:
~'I:is is my Jcclarali~,n of Uomicilr an~1 C'itircn~hip in thc Statc of Fiori~la ihat I am filin~; this day in
a~ri?r~lance, ai~d in conf~~rmity witli S~ction '~?.17, Florida Statutcs.
1 was fonn~rly a Ir~al rrsidcnt of Z~t ~voe ~ , /'Yl o and t
(('ity) (Statr)
residrd at _•'~~v _!_d~~ _r~l.~oo p___~ liowever, [ have chan~cd my do~nicile to
(Sircet anJ Numbrr)
an~i am and ha~~e b~c~~ a bona tidr resident of ihe Statc of I~lorida since ~ day of
now
, 19_Z'~ aaul 1 /Ecsicic at ~13~~~o h~a r _ .
(Strert and Number) '
_ ~ ~ T , . St . Lucie Count Florida '
--~tc~_-~---- Y, ,
(c~iy) '
and this staten~ent is to l~r taken as my decl;iration of citizenship, aciual legal residence and domicile in the State
of I=loricla.
;
,
(Inseri here any pertinenl facis, such ac salr of prope~ty or businrss, ot telinquishment of employment al former
domicile, remo~al nf family to new domicite, purchasr uf hume, elc.) '
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~
Entering children in school:~ ~ Homestead Exemption: ~
2~2~~~ . +r-~
F lE0 AMD RECOROEO • ~
S~. WCIE COUMTY FLA. -
ROGER ?O~TRAS #
CLERK C~~CWT COURT
RfCQRb YEf'~IED.,....~,~,~ " ~
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~ 1 FURTHER CERTIFY that 1 wil) register at tny local address when the registration books reopen, and
; comply with all other requirements of a le,_al resident of this State.
~
~ I FURTHER CERTIFY that I have no intention to return to my tormer domicile, and 1 intenci to remain in
~
~ p R j S f $t . Lucie Count
~o u ~ . ~ , Y,
~ Florida,.n~rmanently. (c~~r~
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~ ' ;T (Name)
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W ` . '
, ame
SwoXry:;t,~ d~tl~ssc~~ibcd bcforc mc this ~ I~- day ot y~'~ 1Z n a ress
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- _ ~.D. 19_7~3-- ~o2T SJ'." L c, ~ ."e _ f.C~_ 33f%s-,~
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:,~4GER POIT , CLERK CIRCUIT COURT
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_I~y_ ut -Cie
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(To tx excculed in duphcate and or~p~n.d f~ted ~+i~h ('lerk Cin~uit Courl, anJ JuplKate v~ilh Taa Assetsor)
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