HomeMy WebLinkAbout2196 C~~:^l~r~~ian c~~ Qc~rn~ct~~ ~~d C~~ize~~~t~i~
~~~c~ •ri~i: srn~r~: nnu c•ouN~r~~ ~cna nssi:ssc~ii, 299854
ST. LUC1E ~~~~UNTY, i~ LOItIUA:
'llii~ i, my clrc!:+ralion cif Uomicilc ancl ('itizri~ship in thc Stat~ of f lorida thal 1 am filing thiz day in I
I
acroril.~i~rr, ;ii~~t in confor~uity ~vith S~:~ticm t 7, Flarida Statutrs. ~
1~vu~ ti~rmcrly a lcg.~l rrsitlrnt ~~f __,._/_-~1?/~~•4 r~'____--- , c~ ~-r-L~?Q.~?! - and 1
(Cily) (titafc)
resi~irci at .d~c~~.'Z l'~4~.~~ .}lowevcr, 1 havc chan~cd my domicilc to
(S1~c.t and Kumb~r)
.in~l am and have l~rrn a hona fide residenl of the Statc of I~lorida since -----1-~-_---- day of
, ancl 1 residc at ~ y ~_-t-o~__r._, N~~ ~1~~-
--.__~_0.~11 ~~r c~----- 19_7~ r ~
(Strrrt and Tlumber)
_ f~' C-;-~-~--------- . St . _ Lt1Cie--- -A_ County, Floricta,
(c•~~y) _
and thit slatemcnt is to bc tak~N as my d.•ciaration of citi•r.enshi{~, actual legal rrsidence and domicile. in the State
uf 1~ (orida. .
(inscri hrrc any prrtinrnt fac~s, auch •rs salc of pruncrty ur busiuess, or relinyui~hmcnt of rmpluyment at farmrr
domicile, rcmi~val ~•f fainily It~ nr~~ Ju~nicilc, purch:.cc uf homt, cic.)
'r'.'~:TLR1'~~~G C~IILDR~?.i II1 SCHOOI.: fiOT~STc.AD EY~TiP'~'IJ`:: ~
Tf enteri.i~ children in scliool,
S
p]_ease l ist their nar~es:
~ e-hg U . ~a ( m ~e r
~ ~
s~'u~ ~ ~ ~t,`` ~ ;
~ ~or~a ~t~u?s
c~ ~ar~a~cr < ~
RECOr10 rERIR
. ~ ~ f ~ ~ ~ y
4
i
~
~ 2~~~
E
~ ~
~
4
i
1
1 FURT}ll;it CE1tTIFY that 1~vill rr~ist~r at my local address whcn thr rcgistration books rcopen, a~~d
comj~ly with all othcr rcq!iirrmcnts of a Ic!~.~1 residcnt of this Statr.
~ 1 1=URTHI:R Ct:R77f=Y that 1 h.i~•c no intcntion to rcturn to m~~ formcr domicile, and 1 intcnd to rcmain in
~ .~1 • ST. LUCIE
~
~ ~---~11 u ~ ~ C'otmty,
~ I=1ori~la. P'=rma~~r~ltly. (c~~'>
~ _ ~ ^
~ . . ,a`• . - • .
f ~ J
~
s C u 1 T.. . ~ ~rn - -
;
~ ; ~ gu~~:~-~~~;
~ ~i-- .s
r.
~1 ' t
~ ~~~~i~~ ~ - ------SIGi1t~`i'tIRL----------
~ ~ - ~
~ _ ~ ~
~ ,~S~ fitild•a~u'~s~ri£~cd bcfore mr this 2 da~~ of
~ - ~ :~;_t_`• :
- ; ;
~ - . v~, ~ ~s
~ `s _ - - - A_!). 1~1--
t ,al 1t1E; t,CtC~te ;S
~ RnG~~ bI'CItAS, CI EZK. C7RCl'T'r Cc)UR'C ' j~lorida
~ '
~ By ~ ~~lJ ne~uL-}~ Cl.erk ,
~ ~
~
~ (Tu bc r.ccutrJ in duphc•rir •rnJ uti~nn;if !d~ d~v~lh l'Irtk ('ircuil Cuurt. :•~pliralr ~~•ith Tax A~cccsot)
~ ~
~ geeK `~`35 P,scf ` ; , ~
4~
L