HomeMy WebLinkAbout1340 ~
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Deciarat~an of Dom~c~le and C~tizenship
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TO THE CLERK OF TH~ CIRCUIT COUAT. 3~~~~~;~ -
ST. LUC I E apv~y. ~,p~pA: .
ThL~ b my declantion of Domicile and Citisenship ia the State of Fbrtda tha~ I ua Gitng thts day iA aeeordanoe. and Ia ;
eonto~mitr .vieh S~ecton 222,17. I~'torida Statutes.
I ~ras [ormerl a kgal resideat at ~ DOp n,1 ~ ~ Cj ~ I
tt~t~1 t8tat~1 ;
resi~kd at ~~~b
~ es ~c~Q r~r ~ However. I hsve eAanged my domicik to
t .~a N~.e.~t (
aAd un and have been a bona Gde resideat of the State of Fbrida siace / q~ _ ~
~v a v~~ , iS~,,,~a I~,t s~ o~x o R 1 a A-ve a.n}-,9-L
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t C rC e , ST . L UC I E~••c..d tvdmeer~ Couacr. Fiorida.
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uid this statement Is to be taken u my deeluation oi citizenship. utual kgal reaidence and domicile in the Stato ot Fbrida.
I f iOR THE PURPOSE OP ENROLL ING Fuit Ffui~iESi ~~?L ~uRfi~i~~~~
CHiIDREN IN SCHOOI~ PLEASE STAtE PLEASE CHEGK: ~
THE 1 R NA"MES:
FILEO ~N!~ ~:f41kpE0
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CLERR i. ::7 ~L~P.T
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~ Oct 6 9 47 AM 'T~
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I FURTNER CERTIFY that 1 w~71 register at my local address when the registntion books reopen, and oomply with all
other requirements of s legal resident of this State.
I FUftTHE~ CERTIFY that I have no intention to return to my former domicile. and I intead to remain in
' C., r.'~ ~ e r~ .t S T. l. U C 1 E County.
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tcar~ .
Fbrida. permaneati; . t
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SKOrn to and subseribed Defore me this day o[
~ . A.D. l9 7~ _ ~
ROGER P01 TRAS, CLERK OF G IRCUI T GOU2T
ST. lt1C I E COUNTY, FLO4 UA
BY:
E TY LERK
~ ao~ 244 ~1341
ACA Form TI 22
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