HomeMy WebLinkAbout0811 Deciaration of Domicile and Citizenship
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TO TlIE CLERK OF THE CIRCUIT COURT.
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ST. LUC I E ~pUNTy. FI,pRtDA: .
This is my declaration oi Domicile aad Citizenahip In the Stste of Florida that I~m Cding thia day in accordance. ~nd in
eonformity with Section 222.17. Florida Stututes. ; ~
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I w~s formerl a legal resident oi ~ and i
~cny~ tsc.c.~
resided at . Howevor.l have changed my domicile to
(Street u+d Numb~r)
aad am and have been a bona fide reaident of the State of Fbrida aince day ei
.19 - and 1 reside at 1 ~ ~ ~ 2` ~ ~ ~ -
~ , (Stewt aud Namberl .
~Cr ~ ST. LUG I E County. Florida,
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and this statement is to be taken as my declaration of citizenship. setual legal reaidenee and domicile in the State oi Florida.
IF POR THE PURPOSE OF ENROLLIhG IF FOR HONESTEAD PURPOSES~
CHILDREN IN SCHOOI~ PLEASE STATE ~ P~EASE CHECK: ~
THEIR NAHESS
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( I FURTIIER CERTIFY that I will register at my local address when the registration books reopen, and comply with a!1 ~
; other requirements of a legal resident of this State. .
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t I FU H~ C TIFY that I have no intrntion to return to my former domicile, and I intend to rem~in in
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~ (Cit~) .
~ Florida, permanenti; .
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~ Sworn to'an~ subscribrd beforc mc this , ~ day ot a
t-- ~ L , A.D. 19 ~
~E ROGER~P01 TRAS, CLERK OF C IRC~JI T COURT £
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~ ST. LI~GIE COUNTY, FLORIUA ,
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~ BY: <<. -L~~ ~l~ C j~lf t~/
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~ CPU~ Y RK
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~ ~ BooK 2`~8 Q~E 810 ~
ArQ Form 7f
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