HomeMy WebLinkAbout0940 D~claratior~ of t?omicile and Citizen~t~ip ;
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„ ~ TO TtiE CLERK OF THE CIRCUIT COURT. , ' - :
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STs LUG 1 E ~pul~tTy~ FLORIDA;
This i~ mr dectan?tion o! Domicile ~nd CitizensAip in the State ot Florida tlut I am tiling thb d~y in accordance. •nd in
coniocmity with Section 2~2.1T. florida Statutea. '
I was lormeri~? a kgsl nsident ot - ,~~?''''~v - - ~nd I
~ ~Ctert ~sut~l
tesidcd at ~7C~' ~V ~ U~~l `~''~'S' ' However. I Aave changcd my domieile to
(St+wt ~nd NwnbK) Z,~-
and am and have Deen a bona fide residcat ot the Stete ot Fiorid~ ~ieee day of
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19~. and I reside at ~~o ~1-E. ~t,-f,~s' L-a-.~ C. ti~/~~
y -~-t-c.-e.~ ST . L UC i E~~ ~ N~~~
G2' ~ c. , county. Floriaa,
lCit7)
and this statern~nt is to be taken as my detlsntiou ot citizenihip. aetual legal resideace and domicile in tAe State ot Florida.
IF POR ?f1E PURPOSE OF ENROIIiNG IF FOR iiOHESTEAO PURPOSES~
~~unn. o~ c~cc ST~Tf PLEASE CHECK: r-~
THEIR NANES: I 1 ~
F~~E~ ~MD RECURi1Ei~
ST LUClE COUNT)' Fta
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4U9'754
I FUEtT~IER CERTIFY that I wili register at my tocal address when the r=gistration books reopen, and comply with uU
other requiremcats o[ a~ega! resident of this State.
I FU~TllE. CF;RTIFY that I haie no intention to retarn to my tormer domicile. and I intend to remain in
-~c--~~-~-~-- ~ ST . L UC t E County.
tCityl .
Florida. permanen~i;.
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S~~~orn l~ and subs~ribi~d t:~•(urc mc this ~ d1Y O~ Y~ J~ y 3 3~ S L-
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ROGEP, 0 i 1iZ/!S~ CL Et2i~ OF~ C I F2C U I T COt~i T
sT. ~.uc i E coun~l~Y, o;~ ~ on
BY: .
~ t~ U T Y Z-L [ R r. ~UU~( 2a7V Fa~i .7~~
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