HomeMy WebLinkAbout0612 1?~clar~~ion alf ~~~i~~~~. a~~d Ci~~ • '
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TO TIIE CI.LHK OF TI1F: G'IRCUIT COURT.
ST._ L.l1C 1 E ~COUNT~'. }~'LORIDA:
This is my declaration of Domicile and Citizenship in the State ot Florida that I am Gling this dry in accordance. and in
contormily itA Section ~'2.1T. Florida Statutes.
I vvas tur_mcrly a legal r~sidcnt ot ~c T./~ /Y1 F' ~f~ /~(-~i ,S'~~ S ttnd I
. tCity> IState)
resided nt - ~~f f~C~ X 7/ ,~~owever. I have changcd my domicile to
(Street and Number) ~s-}
and am and huve beon a bon~ fid~ resident o! the State of Florids since _ ~ v day of
G G~ , ~ .
T .19 . and I residc at ~7 C:~ L% s' 1
(Street ~ad Num6er)
~ T j-- e~ ~ S T. L UC 1 E County. Ftorids,
iCit~1
and this statement is to l,e taken as my declaration oi citizenship. aMua{ legat residence and domicile in the Stnte of Florida.
IF FOR THE PURPOSE OF EMROLLING IF FOR HONESTEAD PURPOSES~
CHILDREN IN SCIIOOI.~ PLEASE STATE PLEASE CHECK: ~
7 H E i R ~i R i~+i E 5:
f lE0 AMD RECORDEO
S~. ~UCiE COUMTr FIA.
ROCEa POtTRAS
CIEaK C~RCUIT CO
~rr ~~~t .i FiiIED
~ MaY 3 12 i3 PM'18
, ~02051-
I FURTfiF:R CrRTIFY lhat I will mE;ister r,t rs~3 locat addrecs when the rcgistr~tion books reopen, and con~~r:y with t,11
othcr requirPments of a legal resident of thi~ State.
I FL'RTHF-,~,CERTIFY t1:~i I hsee s.o i.^.!t.^.!i~n !o mti!*n to tny former domicile, and I intend to remain in
_ /~y f_ i,~^ ' ~ ST . 1_UC I E -
ICitpl . . County.
Florida, pcrm:?nenti; .
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~v?•orn tn ahd su ~scrihed bt•forc mr. t}~is day of r~~? E!~ C` ' ~4 ;
. A.T). 19. / ~
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