HomeMy WebLinkAbout1539 Decla'ra~~on of t~omicit~ a~d ~~tiz~nship
7'O Tlili STATI: AN!) COUl~7'Y ~'/l~: ASSI:SSUR, ~'`~8
ST.~LUCII:, _ , COUN7'Y, FLOltll)A:
Tl~is is ni~~ dcclaratian of Dumicilc and ('iti~r~~shi~~ in thc Statc ot' Floricla that 1 am filing, ihis d;~y in
accvr~la~tcc, ;+nd in canformily witlt Scction 2?2.17, Florida Statutes.
1 was fornicriy a Icgal resident of ~ t~rt Q- ~r k~ and 1
Lr Ucitr) ^ (statc)
rc~ided at _•'3 11 _~1._~ l?~ . However, 1 have changed my domicile to
. (Strcrt and Numbcr)
and am and havc bccn a bona (idc rosidcnt of ihc Statc of rlorida sincc_~ L~( day of
~s~?-' , 19__~~, and 1 residc at _1 s~s L~2~-_.~-~Q
~ (Street and Number)
~~__~~Q~--c~ St. Lucie _ County, rlorid~,
(ri~y)
.~nd this statcmcnt is to be takrn as my .I~clar.ition of citizcnship, actii~l legal residence and domicilc in thc Statc
af rlorida.
(Inscr: hcre any p.rtin.•nt facls, sach u sale u! property or businrss, ut rrlinyui~hm.nt ot employment at tormer
domicile, rrmo:al of family to new ifomicile, purchase o( hame, ete.)
Ei~]'['L':RI~~G CHILDRE?~i I'd SC~iOQL: _ HC)i~CSTEAD ~XEMPTTO`:: ~
If enteri.n~ chi? dreii in school, ~ ~ .
pl~ase list their nanes: 3~~
~`f 'cc n ~e ~cC.Tk ~c n ~ ~i
ctE cou~in?°~ .
CLERR C
7C1~ljT
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URT
G~ H ~ c~.,~ ~`tk k•14.5 _ RECORO rER~FfEO-
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~ 1[~URTIfER CI:RTIf
Y thcit I~~~ill rrgistrr at my local address whrn tl~c rcgistration books reopen, and
~ comply ~vitl~ al) olher mq!~iremci:ts of .i leg.~l residrnt at this State.
~ t FURTHGR CI:R1'IFY that I ha~~c nc~ inte~ition to return to my fornier domicile, and 1 intend to remain in
~ ~'o~~. ~ p ' " ST. LU~I~~
~ - ~ - • County,
~ I~ioFid~(;'(~tsn)anrntly.
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~ : ~ " ~ . • • DIANNE SATICUNAS
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1'URL.
~ ~S ~c~tti~~tt~~~~subscribc~l bctorr me this da~~ of
~ ~`4u„~}~ ~
~ -~_-V _ n.n. i~_-~'_ ls ~~3S S~-
~ "~'~i ing res~
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~ ROr1;P. YO?TR~~S, C1.~:RI. C....CUrT C.CU;tT or-f ~Qrc
z, r~orida
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~ gy c-«_~L~. -c~``~~Deputy C1r_rk ,
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- (T~r bc cxecut~•d in d~~pltr.~~c aaJ nririn:d fil~•d wilh Clcrk !'ucuit C~u~t.. mi dup!h~atc ~cilh '1':+t Asxssix)
~ aoo~~ Pac~1
~ 538
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