HomeMy WebLinkAbout0301 Declaration or uom~c~~e ana ~~~~~C~ ~~N ~
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• TO THB CLEEiK 4F THE CIRCUIT COUA`T. ~ . ~
ST. LUC I E .COUt~t'1'Y. FLORIDA:
Thts is enr dcclaration o[ Domie'~le aad ~ti~en~hip In th~ State of Florlda t~at I am filiag this dar ~u aetordance. and in
~on(urmity witA Seetion 22Z.17. Fbrida Statutes.
~)a~_h~r 1~~ _ ~
~ • aad I
I was tormerl a legal reside~t of
' resided at 3 7- `~'r`'"~'~'~~~'"' However. I have cAanged my domicile to '
(sa..e.ea N~me.r~
~ dsy ot
and am and have been a bona Cde residene o~ the State of Florida ~inee _
~c,c~~cu.f. . lg ` ~ _ and I reaide st ~a/- ~ ~t ' ~
(St~t aed Nombw)
~~t ~~~c,~. . _ ST. LUC I E Couaty.Florida,
(Gc~!
•nd this statemeat b to bs Wcen as my deelsndoa oi eitisen'ship. aetusllegal residenee and domic~e in t6e State ot Florids.
IP FOR THE PURPOSE Of ENROlL1NG If iOR HOMEStEAD PURPOSES~
CHILOREN IN SCHOOI~ PLEASE STATE PIEASE CHECK: ~
• THE{R NAMES:
/ '~4,• ~~~=f~11 . ~~L"n-•
~~J~~Fli~ ~I.cLI')(.~
~ r`u~,?~o ~tc~ ~
tT.1. IE C4UM 1~? f
l ~
ROCE~ PO~1R1~5
C~_Ekl~. C:RCUtT COUitT
~ - • vE~~+F!E~
~ Acc I Q 1 I 32 pN'?~ ~
4~.31.2~
~ I FLTRT~IEK CERTIFY that I wi11 ngister st my local addres+ when the ngistntioa books nopen. and eompl~ writh aU ~
f
{ other requirements oi a kgal resident of this State. .
i
" ~ R CEItTIFY that I hsve no intention to nturn to my former domicile. and I intend to remsin in
k F'[TBTEi~ ik `.~'S~c,~. ST U C I E -~upty.
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tC'it71
y Flonda. permanemi; .
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~ l!k.~s'6C~~~y • (Addees~)
Sworn to and subscribed betore me.this ___L._-. day ot
A.D.19. ~ 8
- ROGER P01 S CIERK Of CIRCU{T COl~2T
x:y .
r4 ST. LUGIE COUNTY, FLORIUA
~ BY : ~~wC Gt~n/ ~ .
~DGl~L.t72 PAl,i t~,
EPUTY LERK
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