HomeMy WebLinkAbout0542 t~~~lar~~~an o7 ~om~~~~~ a«c~ ~~w 1
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TO THE CLERK OF THE CIRCUIT COURT. - ~ ~
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ST. L UC i E (~UNTY~ FLORIOA: (
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Thi~ b mr deelaration ot Domleile and Cilison~hip in the Stato oI Florida that 1 am ftlina thts dU? in aecord~nco. ~nd in
conformity with Scction 222.17. F'lorid~ Statutes.
I Ma+ formc~l a kgal reaident ot ~/~a R S~ Li ~
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residcd ~t .~io~vever. I have ehanged my domicile to ~
l9tn~t aud NumA~) '
and am aad 6ive beea a boaa Cede re~ident ot the 5tate ot Florid~ since g ~r °t
~ ~ 19_Z ~ , and I nslde ~t f ~ 7 02 y~ n `i t? _ ` S ~
(StrMt Nna~er)
~ 1 cz G i P~ _ ST. LUG I E Countr. Florida. `
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~nd this statement is to be taken s~ my decLration o( eitiun~hip. actuet legal residence aad doaticile in the Stat~ ot Florida. _
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Ii fOR THE PURPOSE OF ENROtLING IF i0R HOHESTEAD PURPOSES~
CHII~REN IN SCNOOI~ PLEASE ST11TE PLEASE CNECK: ~
THE 1R NAHES:
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Auc I I i l 06 AM'~8
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; I FURTHER CERTIFY that 1 w11 register at my local address when the registration books reopen, and comply with all
other requirements of a legd resident o[ tbis State.
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~ t FURTNEZ CERTI that I have po intention to nturn to my former domicile. and I intend to remx'in in
~n i- T ti C-~ P ST • L U C I E ~'.outdy,
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~ Florida. permanenti~ .
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~ '~~G~c;.o.~,4 in":'pc _ (Name) ~ t
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_ f SOUY{Y •F~ ~/YL~/~/1 • ~
- (Addle~s)
~ ? ~ day ot .,..~.~ySf~._._r_
Sv?~orn to ~nd subscribed bctoro me tl~is r- .
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~ . A.D.19~ r
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ROCER P01 TRAS. CL~RK OF G iRCUI T COI~tT ~
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~ ST, LUG i E COUNTY, F I.OR t UA ~
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~ EPUTY ~ERK ~
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