HomeMy WebLinkAbout1263 DeclaratiQn of Domicil~ and Citizenship
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TO THE CLERK OF TNE CIRCUIT COURT.
ST . L UC i E CpuNTy, FLQRIDA:
This is m~ declaralion of Domicile and Citizenship in the State ot Florida that I un Gling tAis day in t?ecordanee. a~d in
oonformity ~vith Sectioa 222.17. Florida Statu '
I~vas tormer~ a legal resident of f~- _l-~ z-rz d-~- n L.~d I
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resided at J~ / ~~-~~J - However. I have changed my domicile to
(8ttNt ~ad Number) .
and am end have been a boaa fida resident oi the State of Florida ainee ' da of
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c~~ . f~. ST . LUG 1 E County. Fbrida, `
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aad this statement is to be takea as my declaratioa of citizen~hip. aetual legal residence and domicile in the State of Florida. ~
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IF FOR TNE PURPOSE OF ENROILING IF FOR HOHESTEA~ PURPOSES~
CHIIDREN IN SCHOOL~ PLEASE STATE PLEASE CHECK:
THEIR NAMES: ~ ~
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( I FURTHER CERTIFY that I will register at my local addresa when the registration books reopen. and comply wit6 sll
j other requirements of a legal resident of this State.
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~ I FU T E that I have no i txntion to return to my former domicile, and I int,rnd to remnin in
3 ~ $T . L U C 1 E . County.
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~ Florida, permanen~i; . '
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- Sworn to and subscribed 1?efore me this day of -{.-Q--h-~~ ~
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` ROGE P01 TRAS CLERK OF' C IRCUI T COURT f 1,Ep ~Ntr a~(~~R~ED ,
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