HomeMy WebLinkAbout1754 C, ' ' f'~
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~yv~.•~..~ ~..i, ,.'1~ if._:. ~ •.VJt vl~ . r.s ~~1i • . ~ri . . .
~i~~ ~ri~~: sTn~r~. n~u c~uu~~i ~ ,~x .1ti51.~S(31:. 2'74128-
St .Lucie ~
- - ('Ol?\~I~l', l~f.t)l:It)~1:
'l~l~is is uty drela~:~tic~n of l~c~tnicilr af,cl Citic:n:hi~~ in tlir Stat: „f t~luii~t~? that I:un tilin~~ this ifa~~ in
acranlancc, and in conC~~rmity ~~~itli S~cti~~~i ~,~'.17, l~lurida St:~tut~s.
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I ~vas formcrly a Ir:~:~l msid~iit uf . ~'~~--~~G~rL~~-_-- • ~'.ll ~t~------- a~~d !
~j <<~~~Y) (Stale)
residcd at __~~~L-~~I_C~t~~~~~__~q~c_ , lioa~r~~cr, ! havc ch:~nrrd my ~omicilc to ±
(Strect anJ Hum ~•r) ~
and am s~td havc bcc~~ a bon.~ licir rrtiidrut c,t~ thc Siat~~ of I~lorida siucc da~~ of
now '
-~~~~ll
u~"~__-, 19---~-~-, ancl ! /~~sidc at ~~Ct~~--12A---,~~------ -
(Strcrt and tiumi~rr) i
r St. LUCie '
- . cauncy, r•~or~a.~, -
(c~iy~ ~
~
and this statemrnt is to be taken as my declaratian of citiun;hi~,, act«al le~~?! resicl~ nce a~~d domicilc in the St:ite
of Florida.
(Insrrt here any prrtincnt lacts, such a+ s~lr vf pru~~rr?y or busir.rtis, nr rrlir,yuisl~ntent of rmploymcnt at formcr
dumieile, temo~'al ut tamilr ln ne~v dumicile, purchsu of home, etc.)
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Enterin children in school;~ , . ~ ~
g Homestead ~xemption.
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fIlEO RM:~~'{LJ+~QE~ r~' ~
ST. LUCi: ~CU!1~Y FlA• ,
- ft~'-= i :)1`RAS '
CtE~.k '-:~1' G~UR~ ~ .
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fEe 6 II 35 AM'~'~
2'74128 -
I fURTHLR CCRTII=Y that l~vil! r~eistcr at my loc.~l addmss whcn thc rcgistration books rcopcn, and
' comply with all other re<iuiremcnts of ~ Ic,~.zl resident ot~ t1~is Slate.
1 FURTHCR CEKTIFY that I have no int~ntion to return to my forn~er domicile, and I intend to remain in
i
: ~.'~r C ~ _ , _ St . Lucie County,
: Florida, permanent y. <<''`~ f ~ ~
,
: ; : ~ ~ t11 - ~ ~
, Name
co :
,•y,~~; - ; . _
^i, ip•.~ : _ ~ !
- . ~ . G'~~ ~•t:,: . ~?Vame ~
: . .
- v? : : . - = c . • :
SwarniCbran~ ~~bscriD~tl~ ore mc this da of
• l• . _ai ing a ress
'~'~T•_ ` A.D. 19_74___
. .
ROG~R~P,t~~~'~, CLERK CIRCUIT COURT
. _ _ _ s-~,. . - - BY - - ~ t,~
Cc.~
)e puty\~~l e r
(To bc c~rcutcd in du~~li::dr anJ ~.n; ~n.~) (~Ird ~~~1~ ~'1.~1. ~ ircuit Cnurl.:~nJ Jupti~~at.• with Tas Ac.cccor)
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