HomeMy WebLinkAbout1208 VG41a~ Ai1V~ ~ VI VV~~ i1V11Q Q~ ~W V~ ~~iG~~ ~.7~
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TO THE CLERK OF THE CIRCUIT COURT, 31~1~9
ST. LUC 1 E _ COUNTY. FtARIDA: -
TAts is tnp deelantion ot Domicik ~ad CitheashIp ia tl~s State ot Fbeida th~t I am tillas this da~r ia aooordsace. and ~n
eoatonnity ~vitA Sectioa 222.17. Florids Statutes.
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I~iras formeri s ksal rea~id
-a~t . O and I
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resided at . Ho~?ever. I 6avs ebanged rn~r domic~e to
(8tin~t asd Nwe~l . .
and am aad have be;~ea a bona itde resident ot ibo State oi Florida sinoe da~r of
19- - and I resWe at u•J1 D/~~c~s~ pi~+~-1
aod N )
N ST . L UG 1 E Count~, Florida, ,
tCtyl . ~
and ehis abtcment Is to be t~lcen u my declaration ot citiua~hip. actual kgal nsIdenee and doa~iCile in !he State ot Fbrida. ~
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I~ POR THE PURPOSE OP ENRO~IING IF iOR i10MESTEAD PURPOSES~ t
CMtLDREN IN SCHOOL~ PLEASE STATE P~EASE CHECKS t
THEIR NANES:
.~.a~cc~ ~sT'~
~ Ta.nca ~
i~iwa`~ ca~~
~oc~~ ~o;:R~s ~
_ CLER~t C::.r,U1T Cp~iNT
~fCGR^ Y~s;';L1
SEr S !0 q~ AH'15
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I FURTHER CERTIFY that I w~l regisler at my lo~a1 uddress when the regis4rstion book~ reopen, and comply with att
other requirements ot a legal resident ot this State.
I~U 1'fi~R CERTIFY that I have no ~nt~ntion to return to my lormer domicile. and I intend to remain in
J~~.l~u.t~ ~ Li1t . , S T. L U C i E~ .~~ty.
ICGt~I .
Fbrida. permanenti; .
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Sworn to ahd subscribed betore me thu `s day ot ~~tl j
T
. A.D. l9
ROGER POI AS CLERK OF GIRCUIT COURT
ST. LUGIE COUNTY, F~URIUA
BY: '
C~
EP TY LERK
80eK P~~~ 1~.,OV " ACQ Porm 71 2`l~,
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