HomeMy WebLinkAbout2912 Declaratior~ of Domi+~ile and Citizenship ~
' 304'~85
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TO TNE CLERK OF TH~ CIRCUIT COURT,
ST. LUC I E ~p~~y. ~,p~A: .
This is my dcclaratioa ot Domicib and Citiseasbip tn the Siate ot F{orida that I am i'iling this dny ia aecordance. and in ;
eontormity writh Section 222.17, Florida Statutes. ~ i
l'~4 S~D i~/ and I
I was fo~ a kgal resideat ot -
3.~' S ~A X TO n/ S' 7-' u~r~ ~sc.a~
nsided at . However. I have ehanged my domieile to
(St+~.~t aod Num~r1 ~
•ad am and have beea a bona Cde resident of the State oi F'lorida sinee ~ 7 T~day of
/Vl f} R CN ~ 19 7`S . and I reside at '~`sO~ A A~ C l S L~^~L
n ' (Ste+~t ~od Nuioberl ~
~O /'~.T 1~' i t~ G t. , S T. L UC I E County. Florids, ~
ttx?~)
and this statemeat is to be laken as my declaration of eitizcnship, actual legal residenee and domieile in the State ot Florida.
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If FOR THE PURPOSE OF ENROLLING IF fOR NOMESTEAD PURPOSES~ ;
CHILOREN IN SCHOOI~ PLEASE STAT•E PLEASE CHECKS ~
THEIR NAMES:
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I FURTtiER CERTIFY that I will register at my local address when the registration books reopen, and comply with alf
' other requirements of a legal resident of this Stale. _
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~ I FU~T~iE~ CERTIFY that 1 have no intention to rrturn to my fnrmer domicile, and I intend to remain in
`t F?~T P/C:.~~ C , ST Lut~E ,Coun~y. ~
~ tcn~? . ~
~ I'lorida, pcrmancnti, . • ~
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~ FILEO A~i• RECUROED ~
~ ST. LUC~E Cu'l'NTY FLA. ~
~ ~ RJC;f. F:.'tR~$ I~,
~ CLER~ ~t ;,UIT COURT
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' . . . _ ' ~ - (Addross) ~
~ , ~ ~ ~,i~io ~$-subscribed before me lhi9 3 ~ day of ,
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~~r,.,...,.,:+'/f'L ~uc--- 7.5" .
" 4 . A.D. l9
ROGER POI TRAS,~ CLERK OF C IRCUI T COlk2T •
ST. Ll E COUNTY, FLOF2IUA
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