HomeMy WebLinkAbout0223 Declaration of Domicile and Citizenship
TO THE CLERK OF THE CIRCllIT COURT. ~~~~~j.5
ST. LUC 1 E (;~pv~y, F~,pRIDA:
This is my decfaration ot Domicile aad Citizon~Aip ia the State ot Florida ltuit I am Giing this daJr ia aooordanee. ~nd in
eonformity wtth Section 222.17~ Florida Statutes. -
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I w~as formerlv a legai nsident oi ! n/'~ ~.lL-~ ~ I
Icur1 Is~.t.)
resided a~ U-~ -j Gc~ L'~ . Nowcver. I have changed my doraicik lo ~
lSte+~t aad Num~) ~ St
and am and have been a bona fide resident oi the State of F'torida aince _ ~y ~
!~U/l/P_ .19~
aad I reside at S~~~•~"~j,/~(/G'~ i~ •
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J . ~ lSt~wt ~ed Nnaib~r) -
v ST . L UC I E County. Florida.
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add ihis siatemeni is to i~e iaf~en ~ r~y de~.iaretian uf riti~r~t~ip. art~a! lc~ rcai~~ar~ and doa~irile in ihe Sistt oi Floridn,
If POR THE PURPOSE OF ENROILING IF POR HOMESTEA~ PURPOSES~
CH 1 LOREN 1 N SCH00~~ P~EASE STIITE PI.EASE CNECKS ~
THElR N11MES:
f~~E~ ~MD REC RDEO
iT, ttIC1E COtlM~Y ft~,
ClE XCC
~CUiT Ca~1tT
~ RFCOaa vE~~r~~p~
'w~ l 10 t~ AM'76
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I FURT~iEIt CERTIF'Y that I will register at my loca) address when the registration books reopen. And comply with all
other requ+rements ot a legal resident of this State. .
URTH ~ CF,RTIFY that I have no intention to return to my former domicile. ~nd I intcnd to remain in
, r~r' ~ ~ S T. L U C 1 E _ , County.
IChy) .
Florida. permanenti;.
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5~orn fy:~,dsu~cF~1~e~1 ~etore me this day of ~i~~ S1~ ~vCi
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'.~c~r~ ~ ~.A.D.19 76
RbGER POI.TRAS. CLERK OF C IRCUI T COU2T
ST. LUCIE COUNTY, FLORIUA -
f3Y;
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~ EPUTY LERK ~
rT FAf~
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