HomeMy WebLinkAbout1513 _ -
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~ c~ •r~i~: s~rn~r~ nt~n c•ovtv~~ ~~nx ns~f~:ssc~~z, 2'73919
St.Lucie
____c'UUNTY, r•~,oitii~n: .
11:is is my dcrlaration of Domiril~ ,ind Citii~nshi~~ in th~: St:~tr of I~i.~~i~la tl~:~t I cim fili+~g ihi, ~tay in
accordance, and in conf~rmity ~~~ith Scrti~?n ?22, t 7, Flori~~a Statutr~,.
I was formcrty a tcgal resi~icnt of ~U~~YL'~~~--_--.-___-_--` ~~~".~i!/SAS~_~_ and 1
(Citr) (statr~--
rrsided at -L~~~EC .~ti?So1A!/~_-_----- Howevrr, 1 havr chcu~ged my dontiiil~ to
(Strrrl and Numt+rr) '
and am and have Ucen a Uona lidc resi~lent of the State of I~lorida since _1ST d.~~~ of
~ now . '
fC/.'~/I'df~.ef~ , 19__Z~_._.., and 1 /~c,idr at ~0_8_ S~o ~ ~S'T ------,v ;
(Strret and NumtNrr)
F~2T" ~iC=/I~~ St. Lucie
(c~~r) " Couitty, Florida,
and ti~is st~temcht is ta be tahen as my declaraUon of citizenshir, aetual legal m.idcncc and domirile in the State
uf Florida.
(lnsert berc any prrtinrnt facts, such as salr of propc~ty or businrss, or relinquishmcnt of emplo}ment at fc~tmcr
domicile, temoval of family to new dumicilr, purrhasr of homr, etr.)
Entering children in school:~ Homestead Exemption:
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f1LEO ANi1 RECOAD~O ~
. s;12~'~ i7, IUCt_ i: ~UNTY Fl~
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~ CIERK .i;GU~7 COURT 1
RE~~p:. V£p1~!EO
fEe ~i 3 z3 PM'1~1
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2'~3919 ~
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1 FURTHER CERTIFY t1~at 1 will rcgister at my local address ~~~hen the registration books rcopen, and
comply with all c~ther requirements of a lcgal resid~nt of this State.
I FURTHER CERTIFY that I have no intention to rcturn to my former domicile, and 1 intend to remain in -
fD,er' /~'/~'.P,C'~ S t. Luc i e :
- , County, #
F{orida, permanentty. ~ (~''r~ ~
, - ~
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. ; ~ (Name 3
1
['t ' ' ~ ~ • '
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Sworn,to:atid'sub$ct~ed bcforr me this ~ day of `s~ Sv B~ST~
: • . ai ing a ress
. ••0
' ~ . - , A.D. 19 Z4~. fO.PT {~/E,QC'l ~L.9 .~~4So
ROGER POITRAS, CLERK CIRCUIT COURT
- ' _:...~:.:~-~......z. ~y- . ~C 1Q.,t-
; -eputy ~Ie
(To bc rxeculcd in Ju{~licatr :~nd ~~ri~:in:~l f~k aith ~ 7rr! ("rrcuit ('urrrt. :~nJ du~,li~-atc witb 1.~~ As~cswr)
r r ~~~1~
~on.r.