HomeMy WebLinkAbout2874 Deciara~ion of Dt~r~icEl~ and Citizensi~i ~
p
7'O Tlll: STATE AN1) COUNTY 'fAX ASSI'SSOR,
ST. LUCIE CUl1NTY, [~LORIDA: 3~9
~115 IS Ill}I 11~~~:~1':It1Ul1 Uf UUilil~il~ aiii~ CitiJ.cii~Iii~) lil t~ii', $I~ili' U~ ~'~diit~~ l~i:it ~ dtii ~llliig ZIIiS (~.i}% Iri
arcordancc, and in canformity with Scction 222.17, ~lorida St~tutcs.
1 was font~erly a Icgal residcnt of _._~Y`~ ~ S5 _ ~E''r~~!. l and I
~c~~r) (s~.~e~
rrsidcd at 3?1e_i ~ i. a~ 4 s$ .}lowcvcr, - I havc ciian cd my domiciic fo
(Strtel and NumHcr) .
and am and hav • Ixcn a bona ~de msidcnl of the State of Florida since day of
n~~ ~~nn~~.
191~, anci 1 reside at 3~-~ 2~
~ 1_~~.I.~S~. -
(Stre t and Number)
- ~0,~ ~ ~ ---St. I.ucie County, Flarida,
(c~~r) •
. . . • ~ • • • ~ • e......
.111(1 1I11S Stlt[Cllll'lll 1S IU DG IilKl'1~ Illy uC~la~~iivil u~ iiiiiCii>>~~N, ua,u~a~ ~~~.i~ ii:~iu~~~~~ ai.u UVI~~~M~l~. ~
uf Florida. '
i
}
(Inceri here any p.rtinrM facu, such as sale af pruprrty rx business, or relinyuishment of employment al former j
domicil~, rrmo~al ot famdy to new domicilt, purchau of home, ric J ~
EI~YTERT~.G CHIL~nEN I~: SCHOOL: ~ ti0?'QsSTEAD EXEriPfiTO:V: (
If eiltering children in school, ~
nle~se iist t~e?r names:
- ~
~ t~o~?+m
~ ~uc~E c~~ ~r
CLER!KCCR~ ~t ~ '
PfrOR~ VER1~lEp~~ V ~
~ ~ Z ol ~']S - ~
;
~ 3t~409
~
~
!
~
~
~ -
F
3
~
~ 1 PURI'UER CHRTI~Y that 1 will rc=ister at my local acidress whcn the registration books reopcn, ar.d
~ comply with all other rrquirements of a l~~ai nsident of this State.
1 i~URT11l:R CER77FY that 1 ha~~e no intcntion to return to my former domicilc, and I intend to rem~+in in
~ n ST. LUCI~
~ Yc c--~t- t~r ~ - - - county,
~ ?~lorida, pcrj»ancntly. (c~',~
~ ~
- ' . ~ '~'L ! Q f~ ~J ' ~ ~'~~l'~
! • _ ~
~~~I1~~~~~~1~ .'i~'~ 'i. .
~ , (i~~J j j~•' ~.¢e~ .
,£e', , N~.~.,,
1• , i~ .
~ ~:'~~~t- • 's~,•; ~ ~1 tt'n'.'~-~+2~-1-' -
! i` . • , r J IVa !1 ~1[~L
. _ -j~ . . r~f'A'4:
~ • ' ~i~..
~ '-~,s~i__..:~'~ p :
~ ~ ; ~y? . to .~~~a ~t~~;~~ed ~,~r~~, mr this _ day of
~ ~ ~ 'J~
~ ~ , . ~ ; ` .ri.y..
. • ~ 7 ~
~ , ~ ~ -
~ , , • - Zi in ; c.ress
~ ' :~~~7•fR , rJ.2:.t1: CIRCiITT CUUK~
~ _ , Flurida
~ n,. ~ lnn Y~n nr~ t~ ne-„1t ~ 1 e rk
~ ~ ~ ~ _ t Y . .
J
~ ~
- (Tu bc rx ~led in du;,' • ard ~~ri; m~l tBrJ ~~•ill~ ('Icrk l'ircuif ('uur1. rnJ duplicalo wilh l .s~~r)
~ ORs~ ~ s~
QOOK/+t~5 PACf~rB~ ,
~ , , _ = -