HomeMy WebLinkAbout2942 Declaration of Domicile and Citiienship
~ ~ ~ ~o~os .
~
. .
TO TIiE CLERK OF THE CIRCUIT COURT,
ST. LUC I E Cputv'1~r~ FLORIDA:
Thls ts n~y declaration ot Domicile and Citizcnahip ia the State of Florida that I am Qlirg tAts day in aaordance, and in
eontormity with Seclton 222.17. Florida Statutes. ~ '
l wa~ tormerl a legal resident of I
1(~tr) lStatel
resided at . However. I heve changed my domicile to
(8t»~t sed Numb~r) ,~Q'
and am and bave been a botu lide resident ot the Stale ot Florida since a o day oi .
19~ aad I reside at r.~~~ ~ N a~ hr ~ 1-
- (8t».t.ad N~mber)
I`F_~ Y~ ST . l l1G I E County. Florids,
IGYt~)
and this statement is to be taken u my declaration of citizenship. actual legal residence and domieile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLiNG • IF FOR HOHESTEAp PURPOSES~
CHIIOREN IN SCHOOI~ PIEASE STATE PLEASE CHECKS ~ '
THEIR RAMESt
i
r
.
i
~
C
~
1
,i ,/i~~ f
I ~ ~
`
i
~ j
}
I 1
E ,3
E
~
I
I FURTHER CERTIFY that I will register at my loca! address when the registration books reopen, and comply with aU
~ other requirements of a legal resident of this State.
s
I FURTHE~ CERTIFY that I have no int~ntion to return to my former domicile, and I iniend to remain in
i • ~ $T . L UC 1 E , County,
IGIr! .
E ;
; Florida. permanen~i; . ` ~
~ ~
~ FiLEO Ay~ :;ECOROEO .
~ • ST. LUCIE COUN7Y FLA. ~
~ ROCEF ~D?~~AS ~ :
CLER~ C~'::UIY COURT
. . Rcr,fF^ Y~.; =iE~
; . ~ 31 10 s2 AH'~5 ~
~ ~ ? ~
3 - ~ _ . - { : . ~04808 ' i
. ~ ~
' , ' - _ uns)
- - - ~ - I ~ n l rv a ).5 S 3-
- ~ ~
i t~aa~b..?
~ Sworn toand subscribed before me this 3~ day of
- ~ - ~t ~ ~
; . A.D.19 7~ ~
;
~ !
~ ROGER P01 TRAS. CLERK OF C IRCUI T COURT
~ ~
= ST. LUCIE COUNTY, FLORtUA
j B Y, ~~-~.e~ T~ez l:e.~
.
~ E P U T Y L E R K ~p~ PAGE~~44
~ • :
~ , ~
q Af~O Form 71
e
~ - - - ~ - - - - .:T~,fi~
~ '
c~
~ ~ ~ 'Y . G i~. ~ ti ~ . ; E.
. _ . . - . _ . _ _