HomeMy WebLinkAbout2244 DecEar~~i~~ a~ ~~mic~~~ ~d~d Ci~i~er~ship
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ST. LUCIE--- - ' ('(~UN"I'1'. 1~ LOIttUA:
T11i~ iti my tirclarati~n c+f t)amicilr ;+nd Ciiizcnshi~~ ii~ thr Sta14 of Flc~ri~la that 1 atn filing this day in
.~~~~orcl,ir~ce, ancl itt conformily ~vith S~ctic~n ?~'.17, rlorida Statutrs.
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1 was fornierly a kR.il rc~idrnt of --------,~~l~s~ ~i~•c ~ and I
(c~~r) ~ (s~a«
r~~.i~lcd at -~~-I
~~~_~/~~O~~~t'c.~i- . Howcvcr, 1 havc changcd m}~ don~icite to
(Strcct anJ Numbcrj
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:,nd am and have bcen a Uona fidr. tcsident af the Statr of t~lorida since day of
.wra i~
~ , 19_2~_, and 1 resid~ at G ~~.Fal ~f
~ ~ 'treet and Numbe~) ~
- Y/f.~'~~T~-_Z1~- , U~~~~ County, Florida,
(ci~y)
a~~d this statement is to be taken as ~ny declaration of citizenship, actual legal residence and domicile in the State t~
of I~lorida. _
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(Inserl herr any perunent facts, such as sale of properly or businrss, or rciinyuiahment ot emptoyment at [otmet ~
domici?e, remuva! ut family to nrw domicile, purchase o( home, etcJ ~
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ErITERING CHILDREN IN SCHOOL: ~ HOMESTEAD EXEMPTION: ~a
If entering children in school, i
please list their names: ~
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ST_LU~~ _,:u+~L" FLL ~
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2'16488
I FURTHER CERTIFY that I will registcr at my locai address ~vhrn the registration books reopen, and i;
: umply with all othcr rcquiremcnts of a Icgai nsid~iit of ti?is Statc. t
I FURTHL'R CERTlFY that 1 12avc i~o intention to reti?rn to my former domicile, and I intend to remain in
.f ST. LUGI~ ~ ;
- r-~~~.P=~ - - - , Coiinty,
I~lorida, pcrmanently.
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S~vorn~to.'an~ ~ scrib~~iA bcforc me this .___!L day of .
,
- ~ A.D. 19_74_. U 4 ,
~:OGER POITRAS, .CLFRK C RCUTT COIIRT ~ ress
- ' , Florida 3 s ~Sa
I~y ~ eputy CJ erk
(Tu bc cuculcd in duplir.dc :~nd ~~n~ in.d (0~•d ~c~th ('trrk ('i~cuit ('~~urt. and Jupliralc with Tas Auessor) ~
~ 224 P~~F2243
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