HomeMy WebLinkAbout2847 . , ~i ~
Dec~~ra~iar~ of Dar~~ci~e and Cit~z~r~ship
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'1'U Tlll: S'CATE ANU CUUN'fY "I'AX ASSI?SSOR,
ST. _LUCIC ----~---COUN7'Y, f~LOR1UA:
Ti~is is my ~Icclar.~tio~~ of Damicil~ and Citizcnship in thc Statc of Florida that 1 am tiling this day in
accor~lancc, and in cunformity ~vitli Scction 2~2.17, Florida Statut~~s.
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! was fornmrly a Icgal residcnt of S2~ •~Z~ and 1
(cti~Y (s„«
resi~icd at . Howc.vcr, 1 havc changcd my domicilc tu
(Sireet anJ Numtxr) 7
and am aiid havc txen a bona fide residcnt of the State of rlorida sincc ~ ~ day af
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, 19---• and 1 residc at __~~D 5- _
' c./ (St~etl and Numbet) ~
_ _ , _ . _ St . Lucie County, Florida,
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(c~~Y)
and this statcmrnt is to be tak~•n as my drelaration of citizensl~ip, actual Icbat residence and domicile in the State
of Florida. f
Qnxri herc any perlinent tacts, such as salr uf pru~xrly or businrss, or relinquixhment o~ empluymrnt at former ~
domicil~~ ren~oval uf family to ne~v Jomicilr, purchacr of home, rte.) 4
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E?`1TLRIiiG CHILDRE?~ IN SCHOOL: ~ ~ HOt~ST~AD EX~r1Pi IO^t: ~
If entering children in school,
please list their names:
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FaEO aMu aECOn~ED :
ST. LUCIE COUNTY LA. j
ROGER P01TRA5 `
~ CLENK CIRCUI? COUNT
RECORD VER{FtED
J~ t9 !2 37 PN'TS ~
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1 FURTIIEIt CEItTIFY that I~vill rcgister at my local address ~vhcn the registration baoks reo~~en, and
comply with all other rcquircments of a trgal msidcnt of this Statc.
1 FURTHGR CERTIF=Y that 1 h~vc no intcntion to return to my forn~er domicilc, and 1 intcnd to rcmain in
' ST. LUCIE
. G ~ - , COUllly,
~ I=lorida, pcnnancnUy. <<"'~
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Swo~! '~a~d ~et~~i~'~ brforc mr this day of
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~ ~ fi~ ' . CLCRi: C7RCU1'I' COU:tT ~ , , Florida
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~ By ~ i Deput~• Clerl;
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~ (Tu be exe~uted in dup': .~~r and ~~tirin.~l (ilyd with (7rrk ('i~cui~ Caurt. And du~lica~e w,~h Tax Asse~sor)
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~ goo~?35 PA~2846 ~ . , . ,
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