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Home My WebLink About1429 ~ ~ > Dectar~~ian ~of [~amicile a~d Ci~izer~~hip ; ; , . r ' 4 7'(3 7'l il: S"1'ATI: A~'D ('UUN"1'Y 'fAX ASSCSSOlt, ST. LUCIF. 3C~1S~ - - - - - - CUUN~'Y, LORI i)A: Tl~is is my dictar.~tic~n of Uomicilr and Citir.rnship in thc St,~tc ot' f loricla that 1 am filing this day in accc~rJa~~c~, and in canfunnity with Scction 2''2.17, Florida Statutcs. ~Jp f 1 w~is fanncrly a Ir~;a! resi~lrnt of _.__~21l~B~ G~11.._-__-_ ,~~f~ and 1 4 ~ (ci~r) (s~a~e~ rrsidrd at _.~~~Q . W~~~ . Howcvcr, 1 havc changc~l my domicilc to ( ' t anJ Numbcr) and am ancl have bcen a bona fide msidrnt of ihe State of l~lorida since _ day of _~L9t1~J.~ _ , 19_~, and 1 residr at _ _~~0~ ~~1~~~--- ~ - - ~ _ (5trert and Number) • --~'--~-~P-1~~--Q-----------------• - St.__Lucie - County, Florida, (Cit~ ) sna this statement is to Ue takei~ as my declaration of citi•r.enship, aclual Irgal rrsidence and domicile in t~ie State ~~t~ Plorida. . (lnseri herc any {~rrlincot facls, such zs sale of pruperty or husinrss, w relinquislimcnt of empluyment at former domicilc, tcmoval of family to ne~v domicile, purchasr uf homc, ctc J Ez~~'CLR1`~G CHILDREN 7II SCHOOL: HO:~STI:AD LXLt~IPTIU": ~ If entering childreii in school, ~ please list their names: U C6~ t~~/cc -i G~ "'~.~C~~~ - ~ ~ ~,~i~~ ~~G~,~ ~ ~ ~ C'- .~-n ~e ~ - ~ .~~~a, F ~EO AMC f~ ~ 's ~~RO~fR P'~itA4 c ctEPK C~aCUIt 49!!RT ~ aecoR~ vF~~F'Eo ~ . ~ ~ ~ ~ ~ ~ ! F e ! ~1 V ~ . ~ • ~ 1 FUKTIIl:R CERTIrY that I~?~ill rc~,isicr at my local address ~ti•hcn thc rc~i~trdtia~: books rropen. and ~ romply ~~~ith all othcr rcc~tiiremcnts of a 1cF:~l r~siclrnt of t1~is Statc. ~ 1 FUR1'IIEK CI:RTII=Y that 1 ha~~c no intcnt~on to return to ~ny former don~icile, and 1 intend to remain in ~ ~p~~a~ ST. LLICII: ~ ~ _ -'~Sa4-L--G.~~----- - - _ , C'otltlt)', ~ Floricla, pern~anently. ~ ~ . ? _ ~ ~ ~.v ~ ~ GPiA~ - - - ~ ' ~ . =7'~, .~j; :r ,~~t~l,•t ~ - _ . . . i.} ~ •;~t,s ~Z C~.. /N d cL'f f~ ~ v , - ~ j 0 W~~r~~ ~ ~ '.Y - . #~f :•;l : •~•.,'.r- G• c:~-.., ~ ' ~ ''~~t`-= ~ ;,,~S,s SIGI~A`I'L?RE ~ ~•e ~ ':'Qi ~ ; ' ~ Su~oriS~~~nc] sul~sc~I~esi ~bcforc mc this . clay oC . . ~ ' '~4 ~•~0'~s~`~1.~':~i' •s ~ ~ -~-~%'~,'~~~~~r--------.n.n. i~,_~'_1 ~ e? .t in~; c~ re s ~ ROGCR P0~'1`RAS CI.ERf: TRCU7T COURT ~ ~ _ , r~ o~ ~a~ - ~ ~ I3}• ` ~ ~ Depur_y C~.erk ~ . ~ ~ ` _ (iu ra.~c Icd i~ dupli.•rlr :u~~1 nri~~n:.d filyd ~.i~h ( Irrk ('i~cuit (b~+r1, AIN~ lIU(1IN',IN N'11I1 T:~E A:u•ssor) ~ 600K~e~V PA6f1~p ~ x~ : - - ~ ~ '~r~ F- ,v, LL _ _ ~ . _ _ ~ _ E .