HomeMy WebLinkAbout2297 ~
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s~ . iE~ ' 2`72489
_ _ - - _ . C'UUI~~fV. I~ l.(~Itli)A:
"fhis is m}~ ~Ircl:+i:~ti~~i~ i~f-1)omicilr an~i ('itir~~iti~ltiip in thc St:it~ c~C fforiil.~ that 1 ant ~li~~g this ciay in
,~<iu~~tanc~•. ~i~~d in cot~i'~uutii~' ~i~itli Scrtiu~~'32.17, f=lurid.~ Statutcs.
! was furmrrly a lr;~ai rrsiclrnt of~ t~Iy/L 1~~~~ l~~l } J P`Z and 1
_ , _
` (c•i~Y) (state)
n•~ictrd at __S~i_S_4' ~c ~~•~e~,L'w~ , lio~vc~~cr, I havc changcd my domicilc to
(Strcrt anJ Numbrr) • i
anet am a~id hcive l~rrn a bona fide r~siclent c~f the St:tte ot l~lorida si~ice z`~ ~ day o1'
now ,
fl,~ ~ Yr ~ c°,Z I~) r~ Z ancl 1/~re~icl~ :tt y~` /t y~,t,~ 7'
- - - • - -
(Street and Number)
- f c ~ ' ' h ` . St . Lucie _ County, Fiorida,
(c~~~~)
and this stalement is to be t~k~ n as my declaration oi' citizenship, actual le~al residence and domicile in the State
af Flc~rida.
3
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(inseri her~ any prrtinrnl facts, such as v~le of prop~rty or businric, or relinquishmrnt of employment at formet
duuiicile, remo.al of family to new Q~~n~icile, p~rrchase of hon~c, rtc.)
Entering children in school:~ Homestead Exemption: ~
2'7~489
f1lED A~D RECORDE~ ~
St.lt1C1E ~OUNYY f~ • .
ROCE~ PL~TRAS
~~EpK C~:'CU~j COURT
RECnR~ vfp~~,Ep..^---
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I FURTHLR CERTIFY that 1 will register at my local address when the registration books reopen, and
comply with all other requiremcnts of a legal resident of this State.
I FURTHER CCRTIFY tli:it 1 I~ave no intention to return to my forn~er domicile, and I intcnd to remain in
C ~1 j ) ' , r c e •St . Lucie , County~ ;
Florida, permanently. <<''y> ;
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. ~ . ~ame , ~ -
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Swdcn sub9ci~~ir~i bcforc mc this day of , in a ress
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a'.`.~'"-~`h"` A.D. I 9 _74-. ~ ~ i ~ y:
~ ~,.~'T s ; r,.,~ T ~ ~ f i ~ . :
R POTTRA , CLERK CIRCUIT COURT
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puty Clerk ~
(To b~• ~•A~•cuted in dupliealr :md ~~rit~in.J fd~•d ~.ilh l'Irrl ('ircui[ Court, and Juplicatc with Tax Asscssor)
22~ F~,f2~97