HomeMy WebLinkAbout1310 Declarati~~ of Domicile a~d Citizenship '
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TO THE CLERK OF THE CIRCUIT COURT,
ST. LUC 1 E CpvNTY, Ft,otunA: _
'Phi~ is m~r dectaration ot Domtcile aad Citizeasbip tia the StaLe af Florida t6at 1 am fillag thts day In saosdanee. and in
toaformity with Section 222.17. Florids Statutea. ~ ~
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I was formerl a legd resident ot ~'f ~ r~~ ~O u fl' ~ aud I
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resided at /1 ~e 3 a°~ 2'S' D-~' 'Sc,,~, t~r" •S _ However.I have cbaaged m~r domicile to
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and am and have been a bona fide reaideat of the State ot Florida siaee fl ~ day of
~ ~ .19~ and I nside at ~ ~ ~ ~ ~ n ~e• ~ "
l8tee~t aad Number)
p'~ e l C E" _ ST . LUC I E Couaty. Florida.
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and this statcment is to bc taken as my declarati~n oi citizeaship, aetud legal residenee aad domicile in the State ot Florida.
IF FOR THE PURPOSE OF ENROILING IF FOR H~lMESTEAO PURPOSES~
CF{ILDREN IN SCIi00l~ PIEASE STATE PLEASE CHECKS ~
7HE I R :tANESt
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ROG~r~ FOITAAS `
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I FURTHER CERTIFY that I will register at my loca) address when the registration books reopen. and comply with all
other requirements of s legal resident ot this State.
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~ I FURT~E~ C~RTI,~Y that I have no intention to retum to my former domicile. and I intend to remain in
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~ Florida, permanentl; . ' '
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,,'~ivq'#~t~~d ~ribed beiore me this day of i- ~
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~ A.D.19 7?~ ~
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~ ROGER I Ti"iAS, CLERK OF C IRCUI T COU2T ~
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~ ST. LUGIE COUNTY, FLORIUA
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~ BY:
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PUTY LERK
~ ° R 2~0 PAGE 1309 ~
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