HomeMy WebLinkAbout2492 ~~~l~r«~~:t~r~ c~~ ~~~i~~~~ ~:~d C~~~;~ : ~~~h~~
! c) 'l I f 1: S'TA~'t: A;v t) CUUN'1'Y '1'AX ASSI:SSUk,
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ST. LUCIE ~ ^.`('OUnTY, I~LORIVA: ~
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`Ilii~ i. my ctcclaratic~n of Uoniiciic ~nd Citifrnship in thc Statc vf' l~loricia that 1 ant filing this day in ~
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,~crurilane~:, and in conformity witl~ Sr.ction 22?.17, Flaricia Statut~s. >
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1 wax formrriy a Irgal rcsiJ~nt of ~ - , anil I
~L• ~ (sa~e) ~
. _.~lowcvcr, t havc c angcd my domicilc to
rr~idcd at 9~SG..s-~ - - - - - ~ ~
(St~ert Numbrr)
•~ncl a~n .ind have ~~n a bona tidc resi~cnt c~f thc Statc of rlorida sincc day ot
, 19~~ , and 1 residr a1 ~ - -
(Street and iVumbct)
~ St• Lucie ~ County, Florida, .
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~:~,~i thic ~ta~ement is to be taken as my declaration ot;iti~rnsliip, actu:~l lcbal residence and domicile in the State
uf rlorida. -
, (lnxri her. •rm pertina•nl taels, such as s:~k of pro~urty or busiu~sc, or relinyu~hmrnt of em{.luyment at termet .
domicile, rcmoval ui family ~lo nc~s domicilr, purcLase oi l~umc, rtc.)
L•'~~'I'~R;;!G CHILnR~i: I11 SC~-i()C?I.: ~ '~OMI?S'I`r.:t',D E}:~1R'TIO"~:
I~ enterir.g cllildreii i~~ school,
pleasc lisL- Cheir ~ames:
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- ~ 7~wc,...~.
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. ~ aT~iuc
E couNTr
ROCFF ?Ot;R~S
RFC~4~ yr ~~~u~T COURT
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, - - ~ 16 -1I IO ~i'l
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1 FURTHI?R Ct:RTi1=Y that 1~vilt register at my local address when the rc~istration books reop~n, ard
rum~~ly ~vith all othrr rccit~iremcnts of a ic~ai residcnt of this St1tc.
1 FURTHER CERTII=Y that 1 ha~c no intciition to reh~rn t~ ~ny forn~cr domicilc, :~nd 1 intrnd to remuin in
~ ST. LUCIE
~ Cotisity,
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Fio;tc~~;rEx•~n~S1~:Jldy. , c'it
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. - : - ~ SIGI~IATUIt~
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~.~4~~stt~~c,i~~1 s~i ~cri~~cd I~ctorc mc this "Z G-_ day c~f
~ ~4 . oa Sa~ ~~-nR.~~ _
^''-t-~-~''zc.~~ A.U. 19 _ /
i ing ress
r.UGCR POI"fRAS, CL]'sRi: CIRCtJTT COURT , Florida
~3y ,~.~.G ~i~-~e~'~ nepucy cierk -
(Tu t?r racculrJ i~ ~ aud u~i~i~sal Gkd wit:. t'Mk ('in•uil ('oart. an~ :fupliratr wilh "fa+c As.ussar)
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