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DecE~~~ati~n o~~ ~ami~i~~ ~nd Cifiz~n~hip j
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"1'O Tlfl: S1'A~'1: ANU ('OUN"1'1' '1'AX ASSk~.SSOR, ~9Q60
ST. LUCIE _ CUt1N~I'Y, ~LUltli)A:
izc~~.hi ~ in tl?c Statc of Florida that t am filing this day in ~
Ttii~ is my drelc?raUuiz c~f U~mic~l~ and ( it ~ -
aecar~lancc, :~nd in conformity with Scction 222.17, Florida Slatulrs. ,
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1 was formcriy a lc~;al rrsidcnt c,f '~l~L-~-W--- ~ 1-~ \ u and t
tc~~r) (s~a~~~
rrsidcd at _~QQ_- ~f~'~ML- ~l+~ - • Howevcr, 1 havc changcJ my domicilc to
(Slrrcl snd Number
and am and h:+vc bccn a bana fidc residcnt of thc Statc af ~lorida sinre day a1~
191~!_~ and I residc at _.~f11JDP~~~iZ \,1 '~e ~t~i~~
(Sttret and Number) ~
E C~ ___St. Lticie County, Florida,
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. • . . . ti., .1...-1•,~•,t~nn ..r.•~r~.~~~h~n. ~ctu:,l ir~al residence and domicile in the State
ail(i lfll~ ti1:111'ii1~~~t tv u~. ~ac.:... u., - ~ - . . .
ot' Florida. ~
(b~srri here any pettiurnt facts, such as sale ~A proprtty ~,r bu~inru, ur rcliuyuishment of empluyment a! former ~
domieil~. ~rmo~al of family to nr~~• dumicilr. p~.~chase ot homr. rtcJ
, HOMES'ri.AD EXETIPTIO?`I: ~
I:i•2'CCRI"'G CHILT?REi: I*3 SCIi00L: ~
If eittering children in school, 2~~0
please lis~ their names:
S
- ~~~~~i~~E c~~M~r g~~.
aoc~F. ~o~t~~~ ~
CIERK ~tZCU~T COURT ' `
i1f.CGRD VFP1F'ED.~,.~,^~ r.
J~ 13 I ~3 PM'~5 . ~
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I FURTHER CF:RTII~Y thc~t 1~~~ill rc~istcr at my loc~l address whrn the rc~istration books reopen, and
romply with :~II olhcr req«iremcnts ~~f I~~al rrsi~cni of this Statc.
1 I~URTI{ER CI:RT1t~Y that I h~?cr no intention to return to my fornicr domicile, and I intend to remain in
~ ST . LUCIE County,
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rlorida, pcrnianrntly.
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_ ~ C~ M~?~~I\~ ~ ~A(1 (k1~A ~AQ, ~
. _ 1~i 1'U tU:-
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~ ~ " ' ames Constantine
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~ 'Sw. i and sul~.s~ti~c~! t~ctc~rr nir t~~is day of
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~ ~ ,ROG~R~••POTT ~AS, `'':K CIRCUI"f COURT , Flor'da
_ gy a.~.,~wl ~rtc /`~~-~Deputy Cl~rk ,
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~ (Tn I~e rser 'r.~.~tr :~nd ~r~iyin.il f~lyd wilh ('Icrk Circu~t Cou~l. ~n. .t~: alc ~.i1h Tat Atccss~r)
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