HomeMy WebLinkAbout0897 ' ~ of Domicile and Citizenshi ~
Deciarat~o p
TOTHE CLERK OFTHE CIRCUITCOURT. ` ~32~,~
~ ST. LUG i E pputvTy. ~t,p~DA;
Tf?is u m,? aeci.r.cion or naai«`le aaa aciunabiP w tb~ state oi floria. tb.c t.a, rung ehis ay in ~o~r~danee. ,u~d in
cnntormily wich Seeeion 222.17. Flodda Sacules.
. I was tormerl a kgal t~esident ot ? y~,y~
~e `~~.4. v 0~ u~d I~
1~71 let~
nsided at ~~//I A~e~ ~~Q.t2~ - Howevec. I bave ehaaged mp domic.~s ta
(8tr.~t..d lY~l~1 ~
and am and lu~ve beea a boaa fide resident ot tbe Sbte oi Florida since ~7a~ ~.s -"j dsp o[
~ ~ '-191 ~ ' uid I reside at ~ SG~~'~-1 -
~ aid Nna~)
ST. LUG I E ~,,,t~.~;d,, -
tc~~ ~ ~
and this statemcnt is to be taken as trUr dec4ratioa oi dtisenship. ~dua! kgtJ residenae and domia'le ia tbe State ot Flocida.
Ii FOR THE PURPOSE Of ENROLLING IF POR HOMESTEA~ PURPOSES~
CHII~REN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THEIR NAMES: _
-~Q~!'rle5 ~~1~~? ~ -
~J e 6 U
FILEQ RkL ~ ECOFtDEO
8T. LUC:~ C:?UN1r FLA. ' • ~
' P.4Cc~ -~lTRAS ~
_ ' CI:R[ ~~IT COURt
P~C:)R~ YF~~FIEp~,+~
~ _ Ar~ 19 i I 29 AM'76
~ 332f~~ ~i
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I FURTHER CERTIFY that I w~11 register at my locsl address when the registration books reopen. and oompty w?th all
I, other requirements of a legal resident of this Stale. ~
! I FUA CER'fIF7t thal 1 have no intention to retura to my former domiule, and I intend to remain in
' ~Gu-~-e~ , ST . L u c 1 E , County.
((St~) .
Florida. permanenti,•. ~
.
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_ I • 'r.: - L-~~Gl Q_ ~d v ~
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SKnarniar~d ~~sc,nbed before me LAis.~~ day oi f'dI7 ~i,~`~.L, 1_~,
A.D.19 ?6 / r-
.~'u' . -
ROGE P01 TRAS,L GLERK OF C IRCUI T COURT ~
ST. LUGIE COUNTY, FLORIDA
BY: ~ Y„~ ~
, e rY L~RK ~ ~
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AG!1 Form T[
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