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HomeMy WebLinkAbout1348 / ~ i / ~ ~ ~ • • i • f j~ ~ ~S ~4.YI~~Sl~s~a ?v~ ?:~.e` ~.d'~'~i~.~~.i: t~ti~~~ ~ ~ ~l ~V~! C.:~~~! ~c c~ a,', r~ ~c~ iu: s~c~~~~t: A~u C~~uN~l'Y ~l~nx ~~ss~~~sc~~t, . ST . LUCYI: __~~UUN~ Y, I~ t_OItl UA: - - , ; ~~~is iti-~t?~,Rr d~c•laratic~n uf Dc~micilr :ind Citircnshi~~ in thr Statc ~~f }~{orida that .i?n flin~; Ihis d.~y ii2. ~ i ~ :~~~ur~lanc~, and in runt~nnity wilh Srcti~~n ~22.17, E=loridu StaUrtcs. ~ t~ w,t~- ~ #~s t'c~rii~crly• 1cR:?I rc~idcn~u~' -~II_~ ~N rt-~--------- --Q-~--- anc1~ t ((:itYl (S~alr) : ~ 1L . Howcvcr,~l~avc cSiangcd °m~+ domicilc l~~ . .<< _ ~~.a.~ --~~~~a-~~.--T-~+ . ~ } (Siteei and Non?bcr) S and and hsvc Uccn :i buna ficic nsid~nt of fhc Statc uf T~lorida sincc d~Y ~f " f. - w~ / /J/I , 1~3_~~ , and ~ rrsidc at --~1~~_ ~t!-~~;~L~~~--~---------- : • (Slrert aad Numbcr) ~ . ; St . Lucie _ Caunty, I=lorida, 2; ~~~oR,7'_-.Sr~_vc1~__-----------. 'i cc~~r) ~ ~ ~ .:Eid tl?is staicmrnt is to Ur taken as ~°`~'y dcclaration o{' citizenship, actual lcgai residence and domicilc in the State f Y c~~ ~'~Oft(j3. ' - i (lnscr: here any prrlinent faclc, cei:h as s.ile ot propcrty or bus~nrss, or rrtinyuisl:mcot ut c~nplo)~ment at [ormer y domicili, remuval nt ismil)' to nc~~• d~m~iciir. purchac: ~~f humc. ctc.) ~ 4 E's'~E:tT_~G C~IILnR~?: IN SCI~OOL: J~ HOMES'TEAD EXEMPTIQ'!: If enteriz~g children in school, 1---1 . ~ please tist their names: ~ _ ~ FILEO w~D ~tEC~iaE~ ' . fT t]IC~f i+llit[1'~ Fi.A. R~ ?u:T+tAS SfE~~ ~ :::UIT COUAT l . aF~3aD'Y[~ .'xf0~ . ~ ~EC 11 la 29 ~M'7~~ ~ . ~ 2969'79 I FURI'HER CER7'II=Y that (~vill n;~istrr at my loral address Hfi~n the registration bo~ks reopen, and comply with all othf_r rc~~t~ircme~its c~f a Icgal residcnt of this Stat~. tr~ w•- ~ ~I FURT[II:R C1:RTIFY that~l ha~'c: no int~ntion to return tc°`~y former domicile, andsl mtend to rrmain in S'L . LUCIE Co~tnty, _ _ ~1, _ ~o~_T_---~T-- L~ uc~~---------- - I~I~,rida, ~,~_~•,i~nci~11~~. ' ~ x~ ~ . - ~ -.3---- ~ - ` ~ - - s~~c~~ . . , ~ c;tS iT : . / SwDrllelo'~~i1~t~t. hctorc i;1r t~~~~ -1 tlay o~ • . - 9 . . . • •t~.-~~ c+~. - . ;!1,- U 1~) S. /~12 ~ ~ . - •-~;3:.~ : - ~ - • - - 74 ~'_'2=.3 2~ g~t"c., r s - , ~ _ ; t~'` . ~ c ~ ~ , >~'iJT?."R~'SF: ~:iEi~I: CZft~~JIT C('is??T ~p~T r U~~<_ , F]ori~ia . ~ . . 33~5,~ . :_,t~.r, . C~ DcpuL-y Cl e rk ~y==y - , , (To I~r ea~ utrd i~..hr~}i.~ atr a~r~~ .>nc; ,;l ~ilrJ ~v:14 (''.~1~ f irruit l'ourt. and d:q•l~r~l: ~~ilt ~susuxl . ~ ~ B~OK PAGE~~ _ - _ : _