HomeMy WebLinkAbout0136 f~~~:~~r~~~:~~x~~ ~:~~-~~~«c~~:~ ~~~~~:c~:~~~~~E~ ~ ,
4~9'790
~•o T~~h: ci.l:RK OF'Plf[: CIRCUIT COUR~r,
ST . L UC 1 E~__:___ COUtiTY. F1.OR11)A:
This is my dccla~~tion af Domicilo and Citixrnst~ip in thc Stste of F'IoridA that 1 am Gling this day in accordAnce. and in
cunt:~rmity v?it1~ Sectiun L~.17. F'lorida Slatutcs.
I was tormcrl • a 1~•gal residcnt ot ~n g~' a ~ I n di an a nnd I
lCicy) (Slatel
revded ut R. R. ~t2 F~ox 79G Ho«evcr, l ha~o changcd my domicil'c to
(Street ~nd NumDer) • a
nnd am rnd have becn a Lona Cde rc.ident ot tl~e Statc of Fiorida sinco 15t t~. day ot ;
; :ovember '
2861 San Jer r.i• o Rd. }
~ah tittl~ q .191.~_. aud I reside nt
(6treet and Number)
Phrt St. Lucie ~ ST. l_l1C I E County. Florida. '
(atyl
And this stat~menl is to l,c tnl:en r.s my dc~clnrt~tion oi citizenship. actual Iega1 residence and domicilr in the Slate of F'loride.
IF POR'THE PURPOSE O;F EAROLLING IF FQR NOMESTEAD PURPOSCS~
CNiI•DREN IN SCHOOI~ PIEASE STATE PLEASF_ CHEGKS ~
TNEIR I~AHES:
_p ; fi!D R£CORDED'~ ,
s-IL^ ,r -.~V~tTY FLH• ~
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~ I FURTIiER C~R7IF Y that I will register Et m? Mcal addmss whcn the re~,~i~tration buoks rcopen, 8Rd COIp~)ly K'ILFI t1II ~
i other requircme:,~s of a Ic};al residcnt oi this State.
~ 1 FUR'I'IiF:;t CF:itTIFY thr_t: I ha~•c no int~ntion to rcturn lo r.iv tormcr do~m_~cil~; and I intend to remain in
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Florida, ~~ermancnti;.
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