HomeMy WebLinkAbout1979 .
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2~~29~
"i c) "1'tiE: ST~17'!: ANI) ('UUN"fY 7 AX ~1~~I .SSOl:, ~
St.Lucie `
- - CUUNTY, I~ LUttil)A. •
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'tl~is is my drel:ualion of t)c?mirilc :?nd Citir.~nsi~i~~ n2 tl~~ S~.it~~ c?f 1~1<~,+cis tliai 1 am lile~~~ lhis day in
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a~corJanie, :ind in coiitonnity H~ith Scction ?22.17, 1=lorida tit.ite~i: s. ;
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t was formcrly a Irg:~t residcnt of _ y~~~-~-~~-.- •----!__~~_fZ~ and 1
(C:ily) (State)
r~ sidcd at l~~"
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T-~~ ~_~'~t2~f?_~ r-___,_ I t~•~vcvrr, I have chanfied my domicilc to
(Slrcet a~J I~{wntxr
and am and have be~n 'a bona fidr rrsi~lent uf thr St~te ut f~lorida ~ince I' 7~ day of , i
now ? ~ l
, 19~~., and 1 /~csidr .~t ~~3_
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- ' L? ~ - . St . Luc :.e- - County, Florida, :
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and this statement is to be taken as my declaration of citizensf~ip, :~rtual legal rtsi~lence and domicile in the State ~
of Fiorida. • ' ~
(Instti here any pertineM facts, such as sale of prupcrty or bwirrss, ~x r~linyuishutcut ~~f rmplo~mcnt at fotmer ~
domicile, removal of family tu new domicile, purclrrsr of homc, rti
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Entering children in School: t~ones~ead-Exemption: ~
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I FURTHER CERTIFY that I~vili registrr at my l~:ai ad:i~:~;, ~vhr!~ t}~c rcgistr:ition books reopen, and '
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} comply with all other requirements of a le~~al reside«t of this Stat~ _ `
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~ ~ FURTHCR CrRTIFY that 1 havc no inter.tion to rctt~rn to r;i~ i~,rm~r :inr.~icilr, and I intend to remain in =
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_ - ~ : ~t . Luc~ e County ~
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- Florida, pcr anentiy.
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(Name) i
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SwQ~u.to and subscrjbui~ieforc ~nc thi:: of ,
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_ - • _ ~~.1). 19 . 74 _ ;
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