HomeMy WebLinkAbout0659 Deciaration of Domicile and Cit~zen~hip ~
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TO T'HE CLERK OF TNE CIRCUIT COiJRT, ~
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ST. Ll1C I E CpvN~r~t, FLORIDA: ~
This is my declantion oi Domicile ~nd Cttjzenship in the State ot Florida that I am i'iling this day in aecordance. and in ~
contormity with Section 222.17. Florids Statute~. , ~4
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I was tormerl a legal sident o[ ' ~ t% . ~4-?_7~-- and I
, "Y , C ~ 1 ((~l7) lStatel -
resided at . . However. I beve chan4ed my domicile to
(Stee~t NnmbK) ~ / . ~ ,,I ~ '
`y2(~ ~ aay ot ~
•nd am and h~?ve been s bona fid sident oI the State of Florida aince
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~ ~ L -19~. and I reside at ~ '
(Strest aad Numb~l
~~'i ~ n• p•~~,1~r ST . Ll1C I E Couaty. Florida.
cat,~
and this statement is to be taken as my deelaration of citizenship. actual legal residenee and domicile in the State of Florida.
IF fOR THE PURPOSE OP ENROLLING IF POR HOMESTEA~ PURPOSES~
CH I I.dREN I N SCHOOI.~ PLEASE STATE PLEASE CHECK: ~
THEIR NANESt ' ~
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F~~EO a~U ~ECOROED
ST. ~uC~E C4UMTY FLA.
RCCF? ~~0lTRAS
- Ct[RK C ".;,~~T ~OURT /
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A~~ l 12 42 PN'l5
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; I FURTNER CERTIFY that I will register at my ]ocal address when the registration books reopen, and comply with all
'i other requirements of a legal resident ot this State.
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` I FURT~iER CF.RTIFY that I havc no i~Lc:~tio o~return to my former domicile, and I intend to remain in
~ ~~-Il ~h L-~'~ , ST . L u c i E _ , Co~ncy.
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~ Florida, permanenti; .
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SK~orn to nnd subscribed be(ore me this ~ dny ot
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ROGER P01 TFtAS~, CLERK OF C IRCUI T COURT
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~ ST. LUC I~ GOUNTY, FLOR 1 UA
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~ - EPUTY •I.ERK
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BOOK238 PAGE 6eJU ^Cn ~'ffRl TI
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