HomeMy WebLinkAbout0908 De~laratian of ~l~micile a~d Citizenship
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7Yi THE CLERK OF THB CIRCUIT COUltT. ~~2
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ST. lUG i E ~pU~y. ~,p~~: - .
This,i~ aq declu~tioa ot I)omiciie and Cltisenship ia the StaLe ot 1~1o~Ida tha~ I ain t~ag th4 da41 iA accoedauos. and in
eont~m~cy wtch seceion 222.i~. ~aa sacutes.
. ~ 1 waa t~.legal resident ot md 71ta~ ~L~ . __-__r~. n/ , - „~d I :
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resided at ~ d 1QE IP f-' f~,~
~~i/L% . Howrover. I bsve cbanged m~r domic~e to
(BteMt aA~ NmDK1 •
~ i1ri ~Al~ ~VO bEOA t bOA~ III~ l~BA~ OI LLQ S~~ O~I F~OTIda a1tICA - ~ y'~ ._`aar o~ ~
[L~-~'~ ia_.y1,~.. ~,a t ~ u K~ ( ~ SS.1 - -
(&ewt a~d N~ab~r?
P~ R'("'. _,ST~ I~ ST. LtdC 1 E - Count~. Florida. -
and t~is state~nent b to be taken u mp deeluation oi citiuns6ip. utuat kgal nsidanoe and doneiee~e in the Stata ot Florida.
IF F'OR THE PURPOSE Of ENROLLINC IP iOR HONESYEAO PURPOSES~
CNIIOREN IN SCHOOL~ PLEASE STATE P~E/1SE CHECK: ~
THEIR NAMES:
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l~ ~t' 'r siiuc:
"f~ "CORGEO •
~Otl1~TY FLA.
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!'t EF~. C~: :Utt ~OURT
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~ . Ar~ ly J214 Ft4'16
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I FURTfiER CERTIFIf that I will register st my Wcal address when the re~istntion boolcs reopen. aad_complr .vith ~tll
other requirements of s ie~al resideat oi this Siate. '
~FLIRTHE~ CERTIFY tbst I h~ve rw inteotion to return to my tormer domicile. snd I intend to remain in
_T,(j~~ ~ ,ST-~ ~-l~(~ _ _ ST . L U C ! E . Counl .
(Cic~) . ~
Florida. permanenti; . ~
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Sworn la and aubs,cribcd tor~ me thi~ day of
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. A.d.19
76 _
ROGER PO! TRAS, CLERK OF C IRCUI T GOU2T ~
ST. LUCIE ~OUNTY, FLORIUA ~
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EPUYY IERK n~ ~
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