HomeMy WebLinkAbout0937 D~c~arati~n of [~~mi~i~~ ~~~i G~~~z~r~st~~p
"10 '1~111= STATL ,1\U ('UI;~TY T:~X ASSt~.SSi~R,
ST. LUCIE a3O'1,14;~
- - -(~UU\TY, (=LORIU.~:
Tl~i~ i~ rny drelarali~n ~,r u~~~a~~~i~ a:~a c~~~.r~~>>~~r in ih~ Statc uf [~larida that 1 am filing this day in
acconl:~i~rr, and in confun~~it~• Nith S.^ction _?'_17. Fiorida Statutrs.
1 was forntrrly a k~.~l rt~ici~~jt of ~ , and 1
(c.~Y) (s~~~~)
rrsidcd at 3-~/ .~owc~cr, I havc changcd my domicilc to
~su ~ ~~e~.~
a~id em end ha~~ b~~n a t?otw fidc resiJrnt of thr Statc of Floridci sincc _ day oi~
. 19~~, a~d I n5id~ at ci-~j ~ ~ _ _
(Slrect and ber)
_ _ St . Lucie County, Florida,
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~nd this st;~t~ir.;~it i. to b~ ia~:.n ~s m~• ue:lar~tion of citizenship, actual lerai risidence and domicile in the State
c~f t=lorida_ ~
(Inxr. hcrr aw~ ~~ccicrs-t ixts. ~L:4 sa ia.e' of F~o~rrtr ex bus~nrss, or relinyuuhment of employment at tormrr
do:aic~lc. rem.~.~ ot tar_ul. to ~.c~w J~~c-..i:dr_ r~:r.l.a~. ot Aumr.:tc.)
~'"iEP.I':G C~iTI~ i~'.: I: SCI?OQL: HOt•L~:jTEAD E~Ei~f~'TIO:'~+: ~
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If ei3ter~r.g children_ in school,
please list ~heir t.a<,es:
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k 1 Ft1RTtiER CkRT1F1' th~t I~-i:i n~ ictcr at rny Iexal ad:lress ~~hen thc registratiun books reo{~rn, and
i ro»~~ly with .:Il ~.h~r rzy~.~~::m;~3ts ~f ~ i~~~t r.~i~3~nt of this Stste.
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~ 1 FUKTHt:K i= R~Tlt=Y ti~ue i h~~: o~~ inici~tiore to return to fonner domicile, anc! I intrnd to rcmain in
~
4 .r~<<.~- ~ ' ST. LL'~IE
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~ P.C~ER PC?I'~'I:AS, C3E ~Ii:C!l~T C(:URT
~ , I'loricia
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F B \ ~ c'- ~c ti~t Clerk
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g (Tu Fr ~aetated w~ eritisle as! rtt,;ueil fd~S a~NR 1'?c~' :'r!cuM ('ou~t, 7nd dn(iSk:~le w71h lat A~sctc~K)
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