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Home My WebLink About1318 . . . . . . 1~ / D~c~ara~~or~ af Uom~c~E~ and C~~i~er~~~~~ ~ "1'U 'i'liti S7'A7'l: ANI) COUN'1'Y ~ AX ASSk:SSUIt, ST. LUCTC ('UUN'I'Y, f~LOKII)A: 1'his is my dccl:~ratic~n of Uomicilr anc! Citizci~tliip in thc Stati: of l~lorida th:+t 1.?m filing this clay in ;icror~lancc, and in cc~nformity witli Scctj n 2??.17, f~lorida Statut.~s. , ~ a 1 ~vas forn~crly a Icgal residrnt of ~~"~'l~sl-~~ - , ' and I . (city) ' (State) rrsidcd at S~ -~~~~f . Ilowcvcr, 1 havc changcd my omicilc to , (Strrr! a~~J Nurntx•r) .~nd am an~t h.~vr bcen a bona fii~ic residcnt of tlic Statc of f lorida sincc ~5 day ot' ~1 ~ ~ - - , 19_~~ and 1 residc ai _ aZ~ ~ - • ,.c~~ ~ (Site~t and Number) ` ~ ' St. Lucie ('ount~~, rlo~id~, e~3.!_-~` _ - - (Cil y ) .:nd this statrment is to bc taken as my decl~~r~tion ut citi-r.enship, artu~l leg~,l residence and domicile in the St~te _ ~~l~ l~I~rida. (Inser: herr any pr~tenrnt fact~, ~uch as v!r of pruperty or husiures, or trlinquish~nent of employment at former domicilc, tem~n~l uf tam~ly to ncn d~,niicih, purch~s. o( homc. rlc.) E'?'I'L•'~I`:G CHII.U:tEi~ I;d SCHOOL: NnMCS'1`~AD EXF:;•iPT70'+: ~ Ii enterir.g childr_en ir_ school, ~ please 1 isL L'neir *~z~+,es: j - - f tEO ~K, ~~coRO~o tuci~ COUMTr FLA. CLERK E~~~OlTRAS _ RFCORp Vfp F~ED ~WlRT ~V ~~~.i.~ ! ~ ~~1 1~ oz PM'15 ; - , ` ~ ~ ~ . ~ ~ ~ # ~ ~ ~ ~ ~ 1 FURTIII:K CI:RTIFY tha: 1~~-ill rr~~istcr at my loral address ~+rhen the registration books rcor~_n, and rcimpl~• ~vith all othcr r~:~uiremcnts c~f a l.~al r~sidcnt of this Statc. ~ I rUR7~li1:K CF:R7'II=1' that 1 ha~~c nu int~ntic~n to rcturn to m}~ fonnrr domicilc, and 1 intrnc! to rrnr.iin in ~ ~ ' ST. LUCI~ ~ ~ __.~<~~sz'~ -4~-~-- - - County, ~ I~IoriJa. }~en;tiancntly. t~'"> ~ ~ ~ • ~ ~ z r.- ~5 t,A i'iJR.. ; ~ -~~lc.~.~ a~~ o z.s~ ~ - - - ~ ~IGI~ATUR~ ~ / ~ ~ ~ Sworn to and tiuhscrihr~l hrfur: mc lhi~ da}~ o~ . ~ ~!C~ ~ cisi~iij~j~ ` ~ ~ ~ ~ ,~4::''~ ~ ; ~ - • i'1 _ _ ~ '~'~r , ~ - - - - ~J ~•~~4t1~ ~j+~ . ?1 inf; 1. C 1"E's~; ~ ROGL:lt POI'PRAS, Cl..[:Iti: CIRGI: (;i)UItT :-~:;~.r.._=»•~= :o,?~,; , I'lorida ~ w?t .~l'~t ~ ' " :.a'~~ ~ r. ~._~tl = ~ jl 1J t: ::1' '~~J ' ~ y ~ Y ~ ~v s :.+r ~ 4~~~;~v. : . . ~ ~ -~'Y~~1 t. . . : . ~,i ~ : i v •i ;ri (To 1x e eculeJ i Ju~~lica:~ :u~J ~~n~•nral f~ti•d ~~i1h f lrlk C~c~li1~I'~i+.tt.and Juplir~h• v'h Ta~ A~~rssw.t) . ~ i.. aoat~.W ~asE~318 ~ ~ , ~ ~ : _ . _ , . _ . . . _ :