HomeMy WebLinkAbout0771 ~ Deciara$aon of DomiciD~ and Citiz~~ship .
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TO TtiE CLEItK OF THB CIRCUIT COURT,
ST. l UG 1 E CpUNTY. FLORIDA:
TbJt b niy declaration oi Domicile and Citizen~hip ta•the StAte ot Flo~ds ths! 1 am fil'~ng thi~ d~y ~11 ~ctordante. and in '
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contonaity with Scction 222.17. Florida Statutes.
I wa torm~rly ~ legal reaideat ot ~ E
E~ !/y/P/~ . l' a+wd I '
tCltyl IStat~l
nsided at ' . However. I Aave changed my domicile to
Istra~t +ad Nu~Dsr) •
aed am i?nd have been a boaa tide resideat of the State of Florida since ,1~~ day ot
~ 19~.. and I reside at y~3 %~~7 S~'
lStee~t ~nd Nnmberl
,~e~P~ /~if"/~C' c~ ST. LUC I E County. Florida.
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and this statement is to be taken iu my declaration of citiua~hip. actual legd nsidence u~d domicile in the State o[ Florida.
IF FOR THE PURPOSE Of ENROLIiNG If
FOR HOHESTEAD PURPOSES~
CHI~~REN i~t SCN00t~ P~EASE S7AYE PLEASE CHECK: ~
TItE tR NANES: _
~oSEf>i~ ~1'fN~/~S •
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fll£0 a+~fl REC~~
" _51~. LUEt~ CW,IIq'1~p,. ~
_ ~ ROGER pa~
OIfRK C~R~}~~~~ ~r
RFCOR~ Y£R1Ftfp~,~~~L
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2 FURTHER CERTIFY that I will ~egister at my local address when the ngistration books reopen, and comply with aU
othcr requirements of a legal resident of this State.
1 FIIRTHE~ CEftTIF'Y tJ~t I have no intention to return to my fotmer domicile. and 1 intend to remain in
• fo~ ~ i'iF~ ~ E' , ST . L uc ~ e , County.
ta~>> . .
Fbrida. permancntl; .
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Sworn to and subscribed beforo me this • I.~ day ot
~1f'G ~ P Yt1 h c/L ~ A.D.19 76 -
; .ROGER PO t TRAS, CLERK OF C IRCU! T GOURT
~ "ST. LUC I E GOUNTY, f LOR 1 UA ~ `
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EPUT LERK ` f'"~`
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