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HomeMy WebLinkAbout2142 DEC~acatcan of ~~micf~~ and Cit~z~ns~ip t~ ~ _~ru ~rti~: s~t~n•ri: nNU courv~rY •i'.1X ASSESSUR, 3Q~?n38 ST. 1.UCTE _ rUUN'fY, i~LUltl!)A: ` - ~ < "fl~is is my dcclaration of Domirilc and Citircnshir in thc Statc of l~lorida that 1 am filing this day in ( accorclancc, and in coi~forn~ity ~vitl~ Scctio~~ 222. I?, I=lurida Statut~~s. _ 1~va~ fonncrly ,i Icgal resid~ nt of ---~1~.F_Q1„~~-. C ON N ~~~~1 1 (c~~r) (s~~~e~ residrd at _--_~~~?=~~.F_~~__~o /g ~ . However, I have changed my domicile to ' (St~eet and Number) and am and have txen a bona fid~ rrsidcnt of the State of I~lorida since day ot' -~-~1~~1`~ , 19~ S and 1 reside at -~~I1~'~~ y_D!/T vov~t. I~~d/1TS ~ (St~eet aod l~umber) - St. Lucie ~ . - County, Flc~rida, ' (c~ty) an~1 this statement is to bc t.ikrn as my declarati~n of citizrnship, actual legal residcnce aRd domicile in the State oi~ l~lorida. (Inscri here anv prrtincnt facls, such as sale uf pn.perty or buvnrss, or rclinquishmrnl of employmeit at tormer aumicJe, rrmuval of (amily to new domicilc, pureh:ar uf home, rtc.) ~ FP.'rERI:'::: CNILDRE*: Ird SCHOOL: HOriESTEAD EtEriPT70y: ~ If ente-rii~g cl~ildren in school, ~ - please list ~heir t~ames: ; ; j- ~ \ i ~~V ~e~o ~co~~~ ~ ! st.~uc:E cou~rr FtR, ' • ROGEA ?d;tR~,S • ~ CIER{ CERCUlT C0. Wt` ~ ' f ' Rf.~ORQ YERIFIEO ; } ~ - M~t 1+1 10 3z AN'75 ~ I ~ ~ ~ ~o~z38 ~ - , ~ ; ~ ~ ~ ~ ~ e ~ ~ ~ ~ & ~ ~ ~ ~ 1 FUR'flli:R CERTIFY that 1 will rr~ister at niy local addrr~s when the registration books rcopri~, and - ~ com~~ly with all othcr req!~ire~ncnts of a Irgal r~sident of this State. : ~ . ~ 1 1=uRT~i~:K eH~z~-lr-~' !hat I lia~•e no intention to return ta my tormer domicile, and 1 intend to remain in } ~ ~ ~ , sT, i..uclL : , - - County, ~ r!b,i~~,,~0i~~'~nc~~~. <<~~'Y> ~ . ~y1:. j . ' ~ t r~ r ~ . ~ ~ Q ~ ~ _>Y ^ ' ~ 1 ~ ~ ~ ~U ~ S 1C:Nr?1'~j't~G ~'~AZ ~ N~ J : : ~ , • :=~•-r Q= > "L'~ . t ~~f~ _1!'-~!rc, ~ ~C: ) _ • , S IGi1ATU~E-LG~~ ~ }s ~s s - ' •4'. ~ t~.......• ~ ~ }i~r ~ C~`; ~ ~ ~ Sw-riti~~to•~Hil suhsrrib~d heforc mr tiii,~~ day ef ~ ~ n.n. ~ ev r-~ a o Rf~ ~ - • ~i iSl~ ress ~ ZC~~r;t }'Ol'i'RAS, CLE? CIRCUIT COURT TENSEiv_/~~r¢~%/ , Florid~ ~ _ ~ - ~ s ! ~ ny ~n~c ' Dcpt2Cy Clerk ~~~i w~5 ':~t (To bc cut.J i~ dul~lic~tc anJ ~.ti~:inal fJcd ~:ith ('Irrk Circuit Courl, and dupliiatc a+ith 7az As;cssur) 0 R ~'7 PAGE~~~ ~ 800K r-,~ _ . . . _ . . , . _ _ . - - _x$_ ~r - ~ _ _ . ~ .