HomeMy WebLinkAbout0746 , . . . . ~ i
Deciaration of Domic~le and C~tizenship ~
;
TO THE CLEEtK OF THE CIRCUIT COURT.
sr. ~uc i~ covr,~r. FIARIDA: 32~~ts`~i
This is my dectarstion ot Domicile ~nd Citizea.ship ia the State~ ct Fbrida tha! I un filing thLs day ia aecordanee, and in
contormity with Sectioa 222.1Z. Florida Ststutes.
I wu [ormerl a kgal resident of ~~s~~`~~y~F z~ I
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resided at ~F/P~~/.1' ~7"~ •rlL~ce However. I v ged my domicile to
~sa..e.aa
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and am snd have beea a boaa Cde cesident of the State of Fbcida sinee d~r o~
rY/.e'/~/1?~~~P ____,19~aad I reside at ~A~ v~/~~'c~'~
lStrwt ~ad Numserl
/ O/~~ o.~/ ~!/G/~~ _ ST. LUG I E Councr. Florids.
1C1t71
and this sbtement is to be taken u wy declarstion oI eitizenship. aetual kgal residence and domicile ia the State of Fiorida.
~ IF FOR TNE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES~
CHILOREN IN SCHOOL~ PIEASE STATE ALEASE CHECKS
THEIR NAMES:
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R~ QcE~qKCFF rql~~~~~
•oRt vFR~i~~O~ QAyM
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen; and comply with all
~ other requirements ot a legal resident of this State.
~
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j I FLIR ~ CERTI that I have no intention to return to my tormer domicile. and I intend to remain in
j Q~ ~~p//c ~ ST . L UC I E , County.
~ lCit~! .
~ Florida. permanenci; .
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~ Sworn to end subscribed before me this day of ~
~
~ " ~ ~ ~ ~ . A.D.19 7 6
~ ROGER P01 TR S, CIERK OF C 1 RGU I T COl~2 T •
~
~ S.T. LUGIE COUNTY, FLORIUA
BY: ~ e PAGE 7
' EPUTY IERK BOOK 46
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