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HomeMy WebLinkAbout2646 . ~~:~lar~~~~~~a a~ ~~~rc~~~~~ ~i~E~~f~~~~ % ~ ~ . ; ~~Q9;~;~ ~ TO TI1F: CI.l:R1C OF TIIH: CiitC:UIT COIIItT. ~ ~F ST. LUCIE ~_COUNTY, F1.ORJDA: ~ This ~s m~~ dcclaration of I)omicile and Citizenship in the Stalu of Florldn lhet I am filfng this day in accordanc~, ~and in ~ conformity with Section 222.19, r'laridn Sie?tules, ~ I v~as formcrly n legal resident ot Fairf ax ~ ~ - Virginia dnd I ~ ~ ~ t~tate) ~ s ~ 7 2 3~ P inewoOd S t• Fa 1~s Chureh ,];owPVer~ I have chsnged my domicilo to ~ # residcd al. • ~ . ~ (Street u~d Number) • ~ (City) th~ first ; _ and am nnd have been a bona tidc residenl ot lhe State of Floridt~ since day ot ; ; , ~ June ~ 75 ~ Lot 180 (J lI) ~ ; _._...19 , and I resi~c et• ~ Holiday •ut at St. I,ucie ST. ~ UCIEt=u~~~~ ~ . , County. Florida, ; lCitl) . i ~ and this stAtemenl is to be taken as n~y dectarrtion of citizen~hip. actual legal resider.cQ and domicile in the St~te of FlotidA. . ~ ~ ~ _ ~ . - - ~ : ~18932 " ~ ~ _ _ - ~ - . ~ - ~ FILEd ANp RECOROEO ~ t . . . _ ST. WCIE COUMTY ~LA. ~ ? ~ (iOCER POITRAS ' i~ . ~ ~ - Cl,ERK CtftCUIT COURT . ~ . ~i RECORD YERlFIED...~,,..~„~~ : ! " - , . ' ~ . 13 ~~z w PM r~ : z t . i ~ S - ` ' ~ ~ ~ ~ ~ . . . • ' . ~ ' ~ ? i y_. ~ ' - i i - ~ ( - k . ~ _ I FURTIiFR CE~tTIh`Y tt~at I~vil{ re~;ister at my local addcess when the registra!ian hooks mopen, ar~d comply x~ith all # other requimments of a legal resident of this State: S.. : { I FULt ~I~FR C RTIF'Y that 1 have no intention to return to my iormer domicilc, and I intend to remain io Holiday ~ut at St. Lucie ST, LUCIE ' ' ~ - " . County.. F, tCity} . - _ . Florida, permanently. ' ~ i ~ ~ - ~ = . ~ . " .5 ` t Y+ ' _ _ i - s: t: . _ " . ~ - - • _ ~ l~ . - ~ 3 ~ . r _ M,~ . . ~ - > r~ ~i' rl' _ / ~ . _ ' • ! ~ x~ \ L <L~'t ~C'f ~ ~ ~ /~"~,s- ~ C~ . ' v + . . : Holiday Ou~""at St. Lucie _ , ~ tn~a~»~ - - ; _ Sworn to and su1~ r~x~d hrtore me iliis day ut Jensen Beach, F30]~ida 33457 F - ' : . ' ~ ~ . . . : f ~ A.D. 79l~^ : ~ ~ - _ : /1.,~ tr, - ~ l~ ~'.r, j;r_'` " _^---~-i-- . ~ . y i Na t~- ub1 e:?iSie'd~~tariUYtE •.tfg~ - ~ T?'[y Cornmission ex~;1nL5` . -w-~7S`" - _ _ . ~ ~ _ i - ~ -c - , - . , _ A - ~ : - - o _ = BOGK~'tU PAGE~~~J ~ ; ~ ~ ~ - . . - . ~ :'~z-'';.':-:' - ; (To!?c~o~C~~at~~~n if~i~~~.•~t`; originr.l (i1~;J ti+ith Clcrk Cirruit ('uuri, end dcpliraie w itA Taa Aeeos~or) • . . ~ ~ ACO F'orrn 7t i:'. f - ` • . : _ . . . . ~ _ 4 . . .-_ti _ _ . . . ; - o z c,~tS ~ _____~.~~.ea. ; . ~-~m.-tz=~ a . - . . _ . . . . . ~ _ . . ~ ~ . . . . ? ~ • ~ .J~..t..- ~ 3