HomeMy WebLinkAbout0302 D~claration of Domicile and Citizenship
3sQOz4
TO THE CLERK OF TNE CIRCUIT WUAT.
ST. LUC I E ap~~y. ~,p~p~:
~ a~r a«iu.cro~ ot n~~..aa c~c~~nt~ tn eh. sc.t. ~t ~o~a. eh.c t.m au~ cbc. dar ~s a~a.,,o.. apa w
eoetoreniey .vith seetion 222.17. Ftotid. sacue...
I was t~~ a kgal eesident o~ ~.U~~l~t~l ' _ ~t4 ~ O ~ I .
lQty1 lat~1
r~sided at ~~~~1 : L1.v1o0'D -p Howw~r. I bave elunaed mr doadelM to
I~wt nd N~MrI ~
i
iAd iQl i11d IIaY~ b!!O t bOfla C/~! !'!l~fD~ OI ~M SLiL~ 0~ FIOl~~ ~ACf I aT~ ~f ~
MR~LN- ,19~~ aAd I re~id~ at a S a ~'~1~'at-~•~ 'a~ • .
ISttMt ad Nn~bKf
~t-
o~T S1'~ ~u.c.~ E _ ST. LUG 1 E ~ Couney. Fbrida.
~c~e~? ~
and thb statemeat is to bs Wcen as m~ d~elaratton ot eitlseaal~ip. aetual ksal residene~ aod domieik ia t~s 3tat~ ot Floeida.
Ii i0R THE PURPOSE OF ENROLIING IF fOR HOMESTEAO PURPOSES~
CHILDREN IN SCHOO~~ PI.EASE sTATE 'IEASE CHECK: ~
TM[IR NAMESS
s'~ A~t i 4 IY~ • ~'j tC ~ 1_~'. S .
L o~-~ tl~, • ~Jt~i L LS
:~~~YCIE COUMTY Fl~.
~CCIRCUIT OURT
AECORD YERIilEO •
M~P io aN !7~
~~2~
'j I FURTHER CERTIFY that I w~~l register at ta~ loul addresa w?hen the registration books reopen, and complr .vith all
other requirements ot a kgal resident ot thii State.
~
~ I FUATHE~ CERTIFY that I have ao intention to return to my fora~er domieile. and I intead to remain in
' '~o~T ST • l.~wc.: E _ ST . L u t ~ E , Count~,
ICit~l _
i Fbrida. permaneati; .
{ -
~ .
6 ~
~
~ ..i ~ ~ ; "
~ . ; - . ~ ~ Co~ro~ e
~ . , . ?
~ ~ ~
~
j ~ aa4~1
~ asa
;
- ~ ~
` Sf • ~ 33~5'~
€ Sworn to and subscribed beton this day oi ~
P ~ _
. A.D.19.7
q •
~ ROGER P01 TRAS. CLERK OF C IRCUI T COI~tT ~
~ ST. Ll1G I E COUNTY, FL.OR t UA
~ B,r: .
EPUTY Rx ~ ~
~ ~e~JV ~'af~
~
2
~ '
~ AGO Fnrm ?I 22 ~
~