HomeMy WebLinkAbout2668 Declaration of Domicile and Ci~iienship
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TO THE CLERK OF THE CIRCUIT COURT. ;
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ST. Ll1G i E ~pu~y. F'l,p~DA: _
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This ts my declaration of Domicile and Citi:enship in the SLaie o! Florida that I am Gling this day ia accordanoe. and in
coaformily with Seetion 222.17. Fbrid~ Statutes. '
I wss formerl a lega! reaident of n~- " ~r
r u) ..~~i( Wl I~~ jl and 1
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resided at ~ ~~'r ~t rl s~ , However. I have ehanged my domicile to
(Street ~nd Num~) ,
and ua and have been a bona tide resident of the State ot Florida ainee ~L- day ot ;
7.~ lu,' ~~r :J _,19~. snd I reside at ~~~t n r f u f~??~ u(~
- (St~eet aed Nuaber)
~ f t_ 1- J c ~ ST . L UG I E County. Fbrids.
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and tAis statement is to be taken as my declantion of eitizenship. actual legal residence and domieile in the State of Fiorids.
IP fOR THE PURPOSE OF ENROILING IF fOR HONESTEA~ PURPOSES~
CHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THEIR NANES:
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f~LED A~:~ RECJROED ~
ST.IUC~~ ~OJNTr flA. • l,
ROGi.3 PcZ~TRA$ ; L~
CIE~ t l;=:Ct;iT COURT ~
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with al!
other rcquirements of a legal resident of this State.
I FUR IE~ CERTIFY that I have no intrnlion to return to my former domicile, and I intend to remain in
~."i f ~ ~C': t, , ST . L UC 1 E . Couuty.
(Cit~1 .
~ Florida. permanemi; .
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Sworn to and subscribed hefore me this duy ot ~•'r " f S C~ l- C s~~ ~ C• I~
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± ROGER PO I TRAS, GLERK OF C 1 RCU I T COURT ~
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s ST . l lJG I E COUNTY, F LOR 1 UA
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PUTY LEkK
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