HomeMy WebLinkAbout0284 Deciaration ~of Domi~i~e and Citizenship
~
;
~ . 33223~~ .
TO THB CLERK OF THE CIRCUIT OOt~RT.
ST. LUG 1 E ppUN'TY. Fi.ORIDA: •
This.is mr declaration ot Domicile and Citlzenship in the State ot FbrFda that I am l~as this da~r in ~ooordaaoe. and in _
oantt,rmity ~vith Sectioa 222.1T. florids Statutes.
~ ~nd I ~
~ I was tormerl a kgal reaidcpt ot ~
ICiq?) lStatd
resided st .5~~ J~~~'~~`~'~ Iiowever. I lu?ve ebang~ed apr domicile to
tsv«e..a Nomb~? . M•~..~
and am and hsve beea a bona Cde resident ot tba Stste oi F1orld~ sinee ~ t daJ? ot
f.19~~ aad I reside at °Z~6 3 S Q e~t~n~'~ t e- .
(8tre~t asd Nu~DK!
1~.V C~@ _ ST. ltii: I E Countr. Florida. -
lQV) t
aud tAis siatement is to be takea as mr deelaration ot citi:ensAip. aetud kgal rnsidenee and domic~e ia tbe State oi Florida.
IF fOlt THE PURPOSE OF ENROLLING IF fOR HONESTEAD PURPOSES~
~ CHtLDREN IN SCHOOI~ PI.EASE STATE PLEASE CHECK: ~
THEIR NAMES2 - _ _
obE.~ ~.-~_e ~ ~ ~ -
. .
FIIEG ~ti'~ ~=C„hDEO ~
G~ ST. tUC E CuUMT1r FIA.
fiC.'~~ F~iT S
_ • C:ER1~ ~ :lls: C(~URT
~f~nR. :i-: ~r3E:
A~e 13 91o AM'7& ' -
332~~~
I FURTIIER CERTIFY that I rvr11 register at my local address wThen the registration books ceopen. and comply ~rith aA
other requirements oi a legal resident ot this State. - _
I FURTNE~ CF.BTIFY t1uEt I have ao intention to return to my former domicile. and I intcnd to rer.wn in
_ S• C. ~ ST . L U C I E . Couaty,
(~cr) _
florida, permaneoti;. _
k
. ~ t ~ ` - . .
, , .~'~~,•.1 ' l~ '
.l j~aNkE?2„~
, , _ _
- - _ .
_ _ :
~ ' ' ~ ~t`' _ ? `"C~~S ~O~x~
, . r.~~~ ~ -
~ ~ ~ ~ , ~ ~ c:~ aQ 3 ~ Q.o~~,.. n~ -
. " - . ~N,~~
~ _ c ~ ~ ct 3~ ~rS Z.
~ ~ ~
Sworn to and subscsitned 1 fore me this ~ day of
• ~ , -
1 A.D. l9
7 6
ROGER P41 "fRAS~ CLERK OF G IRCUI T GOl~2T ~
ST. Ll1C 1 E COUhTY, Fi.ak 1 UA
~Y :
~ C~.
~ ! t.TY LCRK
` ' F :n
t z~~. ~P4GE ~
!!r~~; c~.,~:.
r
:~,'&s j`~a°'~: : -
~