Loading...
HomeMy WebLinkAbout1183 Dec~~~a~i~r~ of Qa~~ici~~ ~~~~~~n5~~~ . . 2968~8 i u•rt~~. s~n•t~: n~u cou~~rv~rnx nss~:ssoK. ST• -LUCTE.-~-----_ CUUN"1'Y, 1~LORIUA: ' "1'liis is n~y dcclar..itiun of Uomicilc anct Gitiicnship in thc Statc ~f Clorida that 1 a~n filing iliis cl.~y in acror~l:mcc. .ind in conformiiy ~vitl~ Scction 222.17, rlorida St:~tutcs. .r ! G~and I ~ ; t was forn~crly a lrgal n~sidcnt uf ' ;c~~r) , - ~s~m~e) ~i. - I . Howevcr, 1 have chan~cd my domicile to iCS_ 1~ v a~ - (~trcrt aod Numbcr) ~G~ - 4 • ve txc~t a~iona fidc residcnt of thc Statc of `lorida sincc ~a~~1-K-- day of t# and am and . ha • n C~+~l~ t~ ~ _ - ~ i~... J ~ 'm(yQiL 9~_, and I reside ~t (S eet and N mber) - - St . _Lucie Count~~, Florida, _ ~t:~°~~ . - (tti~Y) ~;nd this statemcnt is to br taken as my declaration ~f citizenship, actual lcgai resici~nce a~~~ ~~t~jj~i~~ jn ~he St: t~ o~ Plorida. (Insrrl here any prrtin~nt facis, such as aa~c uf property or busin~:s, vr relinqui?hment o(emptoymenl at (ormet . dumic~r~ remo~al ot tamil} to ncw• dt~micilc: purrhace ot home, r1eJ ~ ~OMESTEI+D E~M~'TIO`~ : ~ ~ Er;iLi21I~G CHYLDRE~d SCHOOL: ~ ~ If e~~tering chilc~rer in school, ~ ~ please list their na*l~es : 29~848 ~ - fi~E~ x~+~ a£coaoED =T.IUC~E COUNtY fLA. AOGE = PaIT~AS w~ eor n-~,~~~~r wnuss YV~~as? s vvv..• . RfC^Q` ~,tE~:1~fEt~~..~ ~ ~C ~0 44 ~'7~. ~ ! EstabllsLi~a s~aidai« ~ I FURTIIt:R CERTif-'1' that I wiD register at m}~ local adJress when the rcgistrat;o!~ i~ooks reop~n, and rompl~~ ~vith alt other rec;uirements oT a lc~al res+dent of this Statc. , ] rURTHER CERTII=Y that I have no intcntinn to ret~irn to my former domicilc, anci 1 ir.tend to remain 'sn - _ _ ST. LUCIL Coin?ty, - - i "l' . - ai~h~ly - ~c~iY~ FloridaKpcxlal;,, _ . ~ ~ - . - . / S~J: [ ' ' ~t,~~~..: ~~F;~;r., / '~'~~TU'F,r - - ~`3` ~ ' • ~ . ~ ' .l. ~1~ - '4'`~,~ - - ~ : ~ • ' SIGi~~.'. URI: .q,; J ~i,y•2 i~ ~ . - , = l,o : ~~'.bsc~ibed hcf~rc n~c ~his _ ~ ~ day of ~ ~~r~'~o• y~ - - - . 74 ._`rJrtr.:i--------- ,A.n. • i,c11 112~~ I,~;lle^5 RGGGR O~TRA5, CLE::K CIRCU_ IT C~UR ~ ,:'l:~ri.da . ~ 4,~,~ ~f-c,~~ Ueputy Clerl~: Y.~..~ (Tu br care:ited it~ Juplicate anJ uti~~i:~~l fJeJ wi~le ~'S: tk (':rcuit ('ourt, an~i dupi~~ate ~vilh Ta• ' ~ ~ ~ xi~ ' saox ~c~ - - ~ ~ s_,~~ ~ ~ L~°'~~~ ~ ~r _ _ ~ _ _