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t~ j r~i~: ~ i,~~i~r_ c•c~u;.~»~ ~r,» ,~~s~:tisc~i;. 2~~69
St.Lur.ie =
- - - - ('OUti"1'1'. L(Jltll~ll: _
'I~hi. i~ my ~Ir~~laratic~n ~~I~ Domicilc ancl C'itii.tn~hi~, ii~ thc Statc of f~ic~rida th:?t 1 am lilin~; thiti clay iii
:,,~„r~anrr, :u~d in c~~~~(i~rtnity u~ith Sr~iic~i~ ~2~.17, l~t~ri~la Statutrti.
1 w,is formrrl}~ ~c lrz.il rc.i~i~•~~t of - -'r l1_~=ll_=--
z - . ----t-- --L-'-~'- and t
(citY) ate)
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r.~.i~1~:d at ~C~'- - 1: c!- - Howcvrc, 1 havc changed my domicil~ to
- - (tiucct anJ Nwnbrr)
c~~~~l am anct I~a~~c ~~cn :i bona ti~i~ rctiidrnt of thr St:~tc of Florida ~incc --1~~~• d.?y of
nota .
- - - , 19_ _ , and I ~irr:i~tc at ~Q~ ~=',/`..y.~~ft-~f~~-~
- - - - - (Strert and Numbrr)
~:_~~_`~_j,_~~~_--_---- , St. Lucie _ Cou»ty, Florida,
(c~~~~)
;~~~~1 this stateiz~eni is to be takrn as my derlaration otcilircnship, actual legal residence. and domicile in the State
c~i I~loricla.
Qnserl herr any pertimnt facls, such as salr of prupr~ty or husiness, or relinyuishment of employment at former
dumicilr, removal uf fa~nily to nr« domicile. purchase of hume. rte.j
i
Entering children in schooi:~ Homestead Exemption: !._.1
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fri~a a.r. GECORaEO ~
sT.~~c~~ ~~t;NTlf flA. ~
ROGzt: ~~~TR~S `
CLEPK C~ t ;;ffT CQUltT
pr(~nR~
. Y_ •ED
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2'72569
1 FURTEiL=R CERTIFY that t~vill rr~istrr at my local addnss wl~cn the registration books reopen, and
cumply ~~~ith all other requirc~nents of a le,~al rnsident of this State_
I FURTNER CERTIE=1' that 1 h:+~~e no intention to return to my forn~er domicile, and 1 intend to remain in
, ~1
_~cz~'~ T << ' { tl~ St . Lucie CountY,
Florida, pcrmanently. (~'`y> - ,
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S~vbn~.to.and s~il~stribrd bc:o~r ntir this ~~~d~y ot' ~'~7ing a. r ss ~f
. ~ ~ _ 74_. ~ , ~ ~ ~
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ROGER~ B TRAS, C CIRCUIT COURT
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~ _BY lls
eputy Cle k
(jo he cairut.~J in duplic,Ar:,i~d ~~n~•en.~l t~ •,1 ~silh Cb•rl. ltireuit t'~~arl, auJ Ju~•h~.~tc wilh'ia~ A+usu~r)
. ean~ 2z~ F~~~F 2~~9 , . .