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2'~3'72Z
CO Ill~. STA'fl: ANU CUL)NTY 7~AX ASSI:SSUR,
St.Lucie
_ coun~~rti~; ~LOltll)A:
71iis is my dretaratic?n of !)c~micile :+rtil Citizci~xl~ip ii~ !h~ Stalc of Florida ihat I am tilinb ihis day in
:?rcorclaitzc, anJ i~~ canformity wilh Srrtiun ~,?.17. l~lurida Statutrs.
t was fornicrly a lcb:i! rrsidci~t of _~~~~_t C~~~_(~/~L_ ~~'L1 ~ and t
(c'~~ r ) (seacC~
residrd at _ _~~~1~1~ ___~t• , However, 1 have cha~~ged my domicile to .
(Street and Number) {
:+nd am and h~+ve bern a bona tide r~~idri~t af the Statc of' t~lorida si~~ce z~~
h day of
now ~
_ . _ , 19~~ and 1 /residc 33--
C
~--/9~~E- Z ~
' (Street and Number)
~ D!Z ~ l~ C E . St . I.uc ie County, Clorida,
(c~~r~ - -
and tliis statemcnt is to be taRen as my,declaration of citizensi~i~~, actual tcgal reside~ice and domicile in the State
of Flotida.
(Inseri here any pcrtinent Tactc, such as s•rl~ of ptoperty ur busincsc, or retinquishment of employment at tormer
domicile, removal vi family to nr.v domicilr, purchase of home, etc.)
Entering children in school:~ ~ Homestead Exemption: YC~
2'~3`~~2
fILED RN~ P.cCpRDEO
ST. WC~E ;,JUtITr fLA.
Ra~E : a~:'RAS
ClERK C:t.~~13 COUftt
pFf~::i~ :«~F!~p ~ .
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FEa 1 9 ~z RM'7 ~,1~ 's
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; 1 FURTHER CF,RTlT=1' that 1 will rr~;i~ter at my local aciciress ~vh~.n the registration books reopen, and
; comply ~vith all other requiremrnts of a lcral r~sident af this Stat~_
t I FURTHER CERTlFY that I I2:~v~ no intention to return tc> »~y former domicilc, and 1 intend to remain in
~ ~~r- /`",c,c~~ S t. Luc i e
- ~ - _ , - , CountY,
Florida, permancnU~~. <<"y~
~ ~
F , ' _ . , ~~1`~!~~/Z~/~C1JC.fCJC~L~~_~_1~~V l ~4 ~ /~~.{~•aL/
S ignature (husband ) , ~
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' . " ..1 ` ~Signature ~c:*ife~
. r~' = / ~y
S~voni
iv .Uid riib~rribcd brf~yrc m~ Ihi; _ da ot
• ~ ai lIl~ c'1 zess -
; ~ '
~ ='r~ - - - - _ A.I i 9 _.74. .
~ RQG~ !t POI'I'It~`~S , CLERK C T RCU IT COURT
` - - - _
f ~ ~<7..L,~,f
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(Iu IK~ r~.rut~ ~l in Jupl~,..t~ .u~J ~~e~, i f~l, ~I ~th : ! rt ('n. n+~ ! ~~~~rl.:~r,i! ~!~n~h.,ilr ~:h "f.~~ M~c..u~~
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