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HomeMy WebLinkAbout0581 Dectaration of Domic~le and Citizenship 413308 TO TtiE CLERK OF THE CIRCUIT COURT. ST . L UC 1 E CQUNTY~ FLORIDA: ~ Thi~ is my declaration of Domlcile aad Citizcnship ia tho State ot Fbrida thel I am Ciling this dsy ia aceords~ce. and in eontormity with Section 222.17. Florida Statute~. ~ - I was tormerl a legal nsidcat o[ ` ~ I ~ ~ r~ IScat.1 resided at 1,~ ~ ' . How~ever. I heve eh~nged my domicik to - (&rMt ~od Numb~r) ^ ~ ^ and am and have be~n a bona Cide re~ident o[ the State o[ Florids sinee 1\~~~~ P'~~, ~"o-~ dq °t ~ _ ~ ,19~.~. and I nside at ~ ~ ~ ~ ~-rSJ ~ , lst~t ~od ST. LUG I E Count~. Florida, , ~ ~ Ca~~ . . and this statement is to be taken as my deetantion of eitizen~Wp. actual kgd reaidence and domieile ia the State ot Florida. IF FOR THE PURPOSE OF ENROIIING IF FOR HOMESTEAO PURPOSES~• CHILOREN IN SCHOOI~ PLERSC STATE PLEASE CHECK: ~ THEIR NANES: ` F LEO ~MO QECpROEO S~. ~UCIE CQUNIY FLA. aOCER PO~TAAS "IERK CRRCUIT COUR ~ •rc~cflEa . Auc I I 12 so PM'18 413308 - - - I FURTIiER CERTIFY that I will register at my local address when the registrstion books reopen, and comply with all ; other requirements o[ a legal residenl of this State. i ~ I FURTII CER FY that I have no intention to ret~m to my former domicile, and I iatend to remain in . ~ p , ST L U C i E _ County. r- ~ ICitrl . ~ Florida, permanenti; . ~ ~ F ~ ~ ~ ~,~c~e..,q~ , ~ --~~OUfyj : ~ ; -~<<<~.~ y~ ? ~ ~ ; ••o~ ~ ~ U'•,t_ ~ ~:`o~ \ V ~ ~ ~~~••.`•aaF~a?:= Q- ~ c) 1 ~ ~!"~i F~'~ ~ ~ ~~CUN ~Op~~ G lAddreu) , ' ~ Sw•urn t~ and sub~cribc~i b~forc mc this day o[ _ ~y ~ ~ A.D. 19 / ~ ~ rt _ . • _ s ~ RCGFF PGi ~FtASx___f,t_~RK Cl~' C IRCU1 T COt12T - - - - - - - ~T . L l~ 1 f. COUNTY, F LO`21 i)A , - ~ OY: ~ E PUTY ,LERY. ~1 R P~ ~QA ~ 6U41c JOl ~ . ~ ' , :i - - - - - - ~ . - ~ F _ w~~~ ~ ~ ~a".rn-- _ s . ~ ~ ~'z~'"~` ~ ~ ~ ~ ~ ' ? n r~~~ e.~'" z*yE~- ~ +~~~-w. t~ arr r'- - ~ ¢ r _ d~fas~~~~: L°.'~ rI~R~ -r y~> ~n 5,a.,. ~ . Savk a..~~~, Y~.1. _ . . .