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HomeMy WebLinkAbout0988 D~cE~~~~~a~ of D~c~~~~c;iE~ ar~d ~i~iZ~nsh~p ~ ; . 30~~~6 ; ~I~O "1~11~ S'1 ~1"I'I: ANI) ('UUN7'1' 7 AX ASSl~SSUIt, ; s•r. ~.vcT~-- c~c~uh r~~, t~~.c~itit~n: ~ "17~is i~ n~~• d~•clarali<~n of Dc?n~icilr a~ul Citirrnshi~, in lhr Statr of I~lorida lhat I am tiling this day in acr~,r~lai:cc, :i~~cl in cunfurmity ~vith Scctioi~ 2~2.17, I~lorida Statutcs. ~ t I~vas form~rly .i trgal rrsidci~t af ---------~A C~ S 01~---- _ ~ and I ; (('i!Y) (Slate) } n~i~ird at LN~~ f SLtZ~ 1~~___ P~~ 3___~,~~€3~Y ~ Howevcr, 1 havc changcd my domicilc to (Strcrl an NumAr~) and am and ha~r. hrrn a hon.i fidc rrsidcnt of ihc Statc of I~lorida sincc _ day .of ~ _Q C_~-- _ _ , 19_ l and 1 residc at . l ~ C' ~ 1v , [2 ~S c L ~ , _ 3 (Street and Number) r c -----S~ . I.ucie _ Coimty, Florida, y ) .:nd this statcmcnt is to bc t:~kcn as my clcrlaration of citircnship, actual h~al residcncc and domicile in thc Statc uf Flori~la. (InK~~ hcrc any pcrlinrnt fact~, sud~ at vdr uf propeHy or bwinres, or relini~uiil~ment uf employment at to:mer dotnirili•. te~n.+c:d ut famil~ tu nr~v dumi:ilr. purrhaac of hun~~, ctc.) S` E";'~CRI;3G C~III_~RE?: III SCHnOL: N~ }iOI~:STL'AD EXL~IP'1'JU?i: aGa IL er.teritig children in sctiool, please list thei_r nar-ies: € ~ ~ • 1 i FILEO AN~ REcORDED ~J SL f~UCf E' GOUlitlf FLA. S~ , ROCEf~ POITRA$ c~ CIERR CIRCUIT COU~RT~c,v~ RECOAD YERI~tEO \ ~ _ ~ II 2 z9 PM't5 f ~~.18b ~ ~ ~ E ~ ~ ~ ' 1 FURTHI:It Cl:RTIFY that I will rrristcr at my local address ~vhri~ thc r.ristration boo{;s rroreu, and ~ romply ~viih al! othcr rec~!iirements ~f a lr~;al resic)cnt af this Stair. 1 I~URTIff:R CI:RTI[=Y that I have no intention t~ return to my f.~n:irrdomicile, and 1 intend to_remain in ~ ~ C ~ ~ ~ ~ ~ _ - - sT . ~.uclL------- . ('oi~nty, ~ FloriJa, ~~crmanently. tc~~>.~ ~ ~ ~ t Q u ° ,,,...,..r;,s,~: . ; > ~ ~.~,i°~- ~ . ~ .~;~-;;~=Er-• ;y" - - - v` C_l'l ~ ~ R'~ . ' _ S IGi1ATURE ; , • . ~ S~vnr~ to and-sk~lv;~~-i~cd l~rforr n~~~ ri,~. l_I_ ~r ~ ~ :~_.J.-~~'~•~ - - _ _ - n. ~ , ~ rf'- t ~ o ~ S ~ ~ r~,S t ~3 v . _ '-1`•~i .it~~; ~ c aress ~ ~'.~F.?C~~I'£RAS, C] L~:~~ .TRCUIT C(>' ; i: ~ - ~ CRc ~ , Pl_orida ~ - ~ ~ By - ~ D~ ~.~uL}• G 1 e rk ~ - . • ~ 3 t ~ (T~• r~^c t d in Juplicalc anJ uripin.tl fnrJ v:i1L ('i.r{. ('icruit l'unrl. and dupliratr ..i~h Ta~ Asscssot) ~ ~ooK 2~ PacE 98$ ~ . ~ : _ ~ . . ~ _ _ ~i~ ~ . . ~ _ _ ~ _Y.