HomeMy WebLinkAbout2649 Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT COURT. ~
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ST. LUC I E ~pvNTY. FI,ORIDA: ~
Tfiis b nq? declaratioA o[ Doenleik aad Citiseaship in the State ot F{~sida tbst I aai Glins tbts da,~r ta seeordana. and ia ~
contonaicy wtch Saecion 222.t7, ~a sacutes.
I wa t rmer s kgai reaideat of N~ I
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resided at ~ HoNever. I have ehanged ayr domicik to
(&ewt aed NrsDw) • {
aad am and bave beea a ba~a fide nsideat ot the State ot Florjda daes ~LCL /9jS ds~r ot t
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Ju l`~ . l~ ~J - and I reside at
(&n~t nd Nn~~l
ST. LUG I E
, Count~. E'~orid~. _
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and this statement is to be takea as my declsratioa ot dtiunshlp. actual bgal r~aidenee aad domidb in t6e Stste of ~'lorida. . ~
If iOR THE PURPOSE Of ENROLLING IP POR HOMEStEAD PURPOSES~
CHILDREN IN SCHOOL~ P~EASE STATE P~EASE CHECK: ~
TH iR NAME~~~
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i~. ~ GIE ~ ~M
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QLERK ~t:t~~~T COURT t
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I F1lRTH~~i CERTIFY thst I~rill register at my local address .vl~en the registntion books reopen. and compiy ~?it6 all
other rcquirements of a legal resideot oi this State. ,
' I FUftTHE~~ 1~'Y~t I lytYe no ,iat~~tion to rewrn to my tortner domicile. and I intend to remain ia
~ ~fi. ~1 n S T. L U C 1 E ~ County.
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Florida. permaneati; .
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3 Sworn to snd subscribed before me this ~O day of ~ ~'f Y
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~ ~-~~t/ . A.D.19 7~
$ ROGER P01 TRAS. CLERK OF C I RCU I T COl~2T
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ST. L IE COUNTY, FLORIUA
BY: -~.~,t~
~ EPUTY I.ERK
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~oox 243 PACE 2649
AGO Form 71-22
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