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rc~ Tiii: S"I~ATE Atiu c~un rY •~~,~x nss~:s~c~iz, 2'~3149
- St.Lucie _ ^('vUNTI', PLORII)A:
1
Tl~i~. is my dcclaration af Domicilc an~i Citizenship in thc Statc of Florida ihat I am tiling this day in ~
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a~cordancc, and in ra~formity with Section "'"_.17~ Floricla Statut.s. F
i was f~irnicrly a Ic~;al residcnt o1~ ._____~~C~~-~lv _ ,----~~-'-C-L~--- and I
(CitY) (State) -
rrsided at _ -~~~E --~-'L--- . liowever, 1 have changec~~~~nicile to
- (Strret and Numbrr)
and am and hav~ tx:en a bana fide msident of the State of Fiorida since _ day of
now C ~
_~r oAF~-- , 19--~, and !/Frsidc at ---.--.~/D S~ ~o~/./~ ~.J
(Street and Number)
~_~~_C~~ , St. Lucie County, Florida,
~ (citr)
and this statement is to be taken as my der.laratien of citi-r.enship, actual legal residence and domicile in thc State
of Florida. ~ ~
(Inserl here any {+~rlinent tacls, such as sale of property or businrzc, or relinquishment of employment at formet
domicile, remo~al of family to new domicile, purchase of home, etcJ
Entering children in school:~ Homestead Exemption: ~
e,
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, • ~U:EC hMJ REC~RQ~ ~
: ~.l~iCiE GptNtT'~A9LN. ~1
! at0~:~: PC;TRfI$
CLE~R i~'.CutT CS1W~T ~
! RFCCR:; 7~f ic~}-p ~ ~ ~
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~ - ~3149
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~ I FURTHER CERTIFY that 1~vill rerister at m~~ local address when the registration books reopen, and
~ comply with all otlicr requircments of a Ie~al resiclent ot this State.
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~ I FURTHER CERT[1=Y that 1 ti.rvc no intention to mturn to my forn~cr domicilc, and 1 intcnd to rcmain in
~
= J- ~j~~eC St, Lucie , County,
~ - - - _ -
~ Florida, permancntly. (c'`s~~
Sign ture (husband)
~ . , _ ~S_~e h~it/ ~~_~AR~oE~-
r;~ ~ ~~p''• . Signature ~aife~
, ` , . , ~
~ Sw n' ta~nd ~subscn[icct :bcfc~rc mr thi; ~ day of a_s~"~._...nn ~~='~~sc(~
~ 4r - 1`•~ili»g a cd~ress
~ : _
r s'==T-~ y ` - -Q- n.n- -~4---- ~1~-~_
-a ~
= R9G~It:•PO~ ~S, CI.E CSRCUIT COURT
_ • • ~.~~..-_~t-- - -
vd.~ (y r ~ r~
--I3 C U1~. &~C~N~~J r^.iGE
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e j-»1 r y C, c rk
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("fu b~- c~.ccuf~-d in Jupl~..~:r .u~d ~.n;•c~ ~i 1~1, d~ 6 t il t'ir~. u~t /'~,uit.:~t~J di~~ ha:~lr ~titll~ (ai A+arr.~~rl
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