HomeMy WebLinkAbout0183 ~ ' Deciaration o~ Domicil~ ~nd Ci~izenship ~ '
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?0 THE CLEItK OF THE CIRCUIT COU1tT. !
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ST. L UC 1 E ~p~y. ~p~pA:
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ThV b mr deetaeation of Domieite and Citizen~hip in the State ol Flotid~ that I aaa G4na this dqr in aceordance. and in ;
eoata~nity with Sectian 2~.17, Floreda Statutea. E~
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I xat tonricr! a kgil rcaident ot ~ ~~LO~~~~v ~ T ~ '
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raided at l~~ ~ ~ a0'~ s~ - Ho~rever. I have ehanged mr domicile to
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and ua and have beea ~ bona fide nsident oI the State ot Ftwida ~iaee dar ot ~
. i9~ and I reslde at a03 Sk. . D~'C Y1.~Git1 ~C 1
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(SteMt ~nd NamMrl '
S- r7e~ s'v .C~r~ p - . ST . LUG 1 E Count~. Florida,
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" and thv atattmeat i~ to be taken as my deelaration o[ citlzenahip. actual kgd residenee and domicile in the Stato ot Ftorida.
Ii fOR THE PURPOSE Of ENROLLING IP fOR HOMES7EAD PURPOSES~
CHIIOREN iN SCHOOL~ PLEASE STATE ~LEASE CNECKS
THE IR NANES:
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? FItE~ ANB RECORUED
?'i~' l6~K~ - ST. LUCIE COUN~Y FtA.
• ROCER POItRAS
~ C~.ERK CIRCUIT CO T
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I FUBTNER CERTIF'~i tha: I will ~aegister at my loca! address when the registration books reopen, and comply with all
other requiremenb oi a legal resident ot this State.
I FUfiTNE~ CERTIFY thst I have ao intention to return to my former domieile. and I iatend to remain in
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Florida. pcrmanenti; .
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Srvorn to and subscribed before me this day of _ S cf Y 1`L~. _
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ROGER PO! TRAS, CLERK OF C{RCUI T COl~2T
ST. LUCIE COUNTY, Fl~1UA • _
. BY: ~
EPUTY LERK ~Q1~
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