HomeMy WebLinkAbout0307 D~claration of Domicile and Citizenship
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TO THE CI.ERK OF TNE CIRCUIT COURT.
ST. LUC 1 E QOUNTY. FLORIDA: - •
This b my decl~?ntion ot Domicile ~nd Citizenship In the State ot Florida that 1 am tiling this dqr in accoidanee. and in
coaformily with Section 222.17. Florida StutuLes. .
resident oi ~d, ~ , and I
I was formerl a le~al ~ ~
S- n S f~ ~
G j- _ - Ho~rever. t have ehanged my domicile to
(8tro~t ~od N~miMr)
~ ` ~ - ~ S'~ dq ot
aad am and have been a bona Cde resideat oi the State of Florida sinee L_ ~ 4
J-t6 ~_/}k
-19 . and I reside at 1~'rK ~ S~~c: /ho B /f~ o~- c- ~~-R.t- -
(gtreet ~ad Number)
. ST . L UC I E County. Florida,
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and this statement is to be taken as my declaration of citizenship, aetual kgal residence and domicile ia the State ot Florida.
IF fOR THE PURPOSE OF ENROLIING IF FOR HOMESTEAO PURPOSES~
CH.ILDREN IN SGHOOI~ PLEASE STATE PLEIISE CHECK:
TNEIR NAMES2
~ ~~443
~ 4EQ ~f{~ AfC RD p ~
4~• ~.UCIE COUM~r F~A, , i~
ROGEr ~ oitRAS ~ ~
~ CLERK C~~~UIt COUNT -
. RECCR~~ Vr~ `rIED
. A~ 1 II sa AM'75
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E I FURTHER CERTIFY that I will register at my iocal address when the registration books reopen, and comply with all
i other requirements ot a legal resident ot this State.
f
6 I FURTHE~ CERTIFY that I have no intention to return to my tormer domicile, and I intend to remain m
~ . j r P~~_~~~- , ST LUCIE ,County,
~ ICity) .
~ Florida. permanenti; .
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~ Sworn tu and subscribed betore me lhis day of
_'L'c.~ A.D.19 7•S -
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~ ROGER •P01 TRAS CLERIC OF C IRGUI T GOUtT
~ ST. L IE COUNTY, F~ORIUA
~ BY : c~c ~ -
~ ~ EPUTY LERK -
' ~ BOOK ~S PAGE JO7
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