HomeMy WebLinkAbout1016 . . . , , h~ ~ ~
Declarat~on of Domic~le and Cit~iens p
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E ____CpUNTY. FLORInA: 3~~~~
This ts my deelacatioa oi Domicile and Citisenahip ia tbe State of F'brida that I un Ciltag this dap tn aceord~aoe, and in
oontormity ~rith Seclion 222.1?. Florida Statutes. , ~
I wu tormerl a legal resident oi ~ l~ ~ ~ 0 2 K . lU` and I
. , tacrl ~s~.cel
resided at ? a J~ ~ G P~ A C~_ - - However. I have changed my domicile to
(StrNt aed Nmnbsr) '
aad am aad have been a boaa fide nsident ot the Siate of Florida sinoe , day ot
/t715~ l~ e~ 19~ and I nside at 3~~o ~l G 1 n' ~ V£-
(8te~e~t and Nnmber)
~ ~ ~Jc~ / ~ _ ST. LUC 1 E Count~.Fbrida.
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and this statement is to be taken u m~r declantion of eitizenship. actual legal t+esidenee and damide ia the Stats of Fbrida. ~
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IF fOR THE PURPOSE OF fNROLLING IF FOR HOMESTEAD RVRPOSE ~ ;t
CHILOREN IN SCHOOI~ PIEASE STATE PLEASE CHECK:
TNEIR NAMES:
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fILEO AyD KECUROED ,
ST. LUCIE C~UNTY FtA, i
ROCEn ~OITRAS ~
CtERK C; ;CU~T COURt
~ RECO~{~ ;IEatr?ED....,,,,~,;~ .
Ar~ 10 I I 13 AN '15
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I FURTHER CERTIFY that I wilt register at my local address when the registntion books reopen. and comply with all
~ other requirements ot a legal resident ot this State.
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; I RTHER TIFY that Z have no intention to. return to my former domicile. and I intend to remain in
~ i.-~'T L- ~J / f. ~ ST . L U C 1 E County.
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~ Florida. permanenti; .
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~~1•._ (Name) ~
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~ ~ • (Addrewl
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~ .S~:n . bxfurc me this day o[ 3 Q~~
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~ A.D.19
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ROGER PO TRAS CLERK OF C IRCUI T COURT
ST. ~UCIE COUNTY, F~ORiUA
~ BY:
~ PUTY IERK
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~ ~~238 P~1015 :
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