HomeMy WebLinkAbout2646 . •
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7O "I'lll: S=1~A"1'f: AI~I) ('OUN 1~Y 7'AX ~~SSI~:SSI)It.
St.Lucie
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11tis is my dcciaration oi~ Domicilc and ('itir~nshi~~ in thc St~~~• al~ f~lurida ih.it 1 am filin~ this cls~y in
arcoraancc, and in cont'urmity with Sertic,n ??2.17, Flori~la Statutcs.
t was fonncrl~~ a Icral resi~t~~nt of - ~rand l
~c:i~r) (si~~r)
r. sidcd at _ . Ho~vcvcr, i havc changed my domicilc to
(Slrect and Nu~ulxr)
.~nd am and have bcrn a bona fidr residcnt of thc Staic uf I~lorida sincc day of ;
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now -
~ , 19 and 1 /~residc at - - -
(Strcct and Number)
S~ . Luc ie _ County, Florida,
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(c~~r)
and this slatement is to be taken as my declaration of citizenship, actual lrgal residence and domicile in the State
of Florida. ~
(Insert here any pertinrnt facts, such as sale of property or business, or relinyuishment af employment at former
dumicile, removal af family to ne~v domirite, purrhase of home, etc.)
Entering children in school:~ Homestead Exemption: ~
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F LE-Q Ak.~ RECORDED ~
i~.luClE L'OUMTy fLA.
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COU~~'~ .
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1 rURTt1ER CERTIFY that ( H~ill rrgistcr at my local address when the registratio~z books rcopen, and
~ COlllj)~y with all other requiremcnts of a Ie,~al resident of this State.
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~ I FUR7'IIER C1:RTIFY that l lia~~c nc~ intention to return to my fornier domicile, and I intcnd to rema~ii in '
~ St . Lucie County, t
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~ t=lorida, pcrm.+ncntly. tc~cr)
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_ " ~ - --S igna~ure (husband )
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. ~ ~ = - i i ture ~.*ife
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n,•. ~ ' : : ' / (o ~ /C~ i'~~
~ Sworn-'t ~'tn~d~su$~ cjibcci beforc mr thi~ _ clay of
~ . . ~ cb •.ai in~ a ress
- n.i~. t ..74__. T ~ ~
GER POITR , CI.ERK CTRCUIT COURT
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