HomeMy WebLinkAbout1304 '1
tion of Domicile and Citizenship _
Deciara
• ~ 3US'7'~2
TO THE CLERK OF THE CiRCUIT COURT.
ST. LUC 1 E COt~Jt~1'x. F't.oalnA: . !
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This is my declantion ot Domic~e and Citisenship in the 5tats of Florida that I ua GIIt?g this d~y ia uoordance. and ia ;
watomuty wlth Sectioa 222.17. Florida Statutes. , .
f/~ 1~ y~ E T~ i s r t _ and I
I wu tormerl a legal nsideat ot -1 ~ 1
t~
r 1 ~g~~ ,
1`l c~; 1.7~ X ~ T A ~ V~- . However. l bsve changed rn,~ domiale to i
resIded at (sae.c.udN~b.el ~ ;
/1 y 7 dn7~ F
and am a~d have been a bona Cde resident oi the State oi Florida siace
_ 19 - and 1 reside at a 7 3 ~ Y/"1S' E s s V t.
(Street sad Number)
ST. LUG I E County.F'lorida.
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aad this statement is to be taken as my decl~ration oi eitizenahip. acLual legal residenee i?nd domie~e ia the Stata of Fbrida.
IF FOR THE PURPOSE Of ENROILiNG IP FOR HOMESTEAD PURPOSES~
CHILDREN IN SCHOOL~ PLEASE STATE ~ PLEASE CHECK: ~
THEIR NANES:
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~ 1 FURTHER CERTIFY that 1 will register at-~^y local address when the registration books reopen. and comply with all
other requirements ot a legal resident ot this State. ~
~ I FURTHE~ CERTIFY that I have no intention to return to my former domicile. and I intend to remaia in
/"r /'.~-u<< ST. LUC1E .County. ~
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Florida, permanenti; .
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Stvbcn~to and subscri.~ed beiore ir:e this day ot s ~ Y t'~ rs'S ? E
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~F ~ ' , , A.D. 19
7~
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ROGER PO i AS. CLERK OF C I RCU I 7 COURT
~
ST, LUGIE COUNTY, FlOF21UA
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BY ~t-~~
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' E TY ERK
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BOOK~+~ PACE~JOJ ~co F•~~~~~ 7~
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