HomeMy WebLinkAbout1504 Declaration o# Domicile and Citizenship
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To~ ct.E~c oF~ cQecurrcovnr,
ST. LUC 1 E ~pvtv~r~t. Ft,pR~pA:
ZLb ls aU deelaratioei ot Domkik and Ctti~saabip ta tbs 8tat~ oi Floeida that I aaa tiW~ this da,~? !n aeeocdasa. and in ~
eoato~aait~ wita Seetion 222.17. F'lorida Statute~. .
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I was t e
n~ ~ kgal resideat ot ~~~/rJ~l_/~/J'~Z - aad I
e~esided sL 7~~-t.~~~3'~~ - Ho~rev~e. I have
obanged np domicile to
IBtrMt ~d tiw~l -
iAd ilq iAd ~1/e b!!A i bODi ~0 T'lS~eA~ Of ~$~tA Ot ~'`~Of~i f~R00 ~ 0~
• -1! ~ aod I r~ide st / O .CS~
l8te+~t~dIi~~t1
f~. l.~rcc ~'.1o~~dq _ sT. Lt1CIE co„o4.~,~..
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and t1els stateroent Is to be laken as eny daelantion of dtiuaship. aetual legal residenoe and domieile ia tAe 3tate oi Flarida.
If POR THE PURPOSE Oi ENROL~ING If iOR MOMESTEAD PURPOSES~
"CNIIOREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~
TNEIR NANES:
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~ - ST
lUC E c~OUNTY FLA.
~ ROGE: POttRAS C
' CLERK Ct;CUiT COURT
RECORt? Yr~~F,r~
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~ Notr 5 2 29 PH'75
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I FURTNEB CER1'IFY that I w~l register at my local addreas when the registratioa books reopea. and eomply w~ith all
~ otber reqnirements of a legsl nsideat ot this State.
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~ I ~ ERTIFY thst I,~'ave ng tention to nturn to my former docnieik. ana I intend to remaia in -
j " Fv~ /~j e/~~ E ~i~n ~i~ _ ST . L U C 1 E . Gounty.
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€ Florida. permsnead; .
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~ Sworn to and subseribed betore me this day ot F~ • f
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~ //[~(fP ~ A.D. l9 ~
~ ROGER I AS CLERK OF C I CUI T COUZT
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~ ST. LUGIE COUNTY, fLOR1UA
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~ BYt
PUTY I.ERK ~ R ~45 FACE~~
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