HomeMy WebLinkAbout0911 Declaration of Domicile ~nd Citizenship / ~
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TO Tt1E CLF.RK OF THE CIRCUIT COURT.
ST. LUG I E COUN'rY. FIARIDA:
Thu is my dccleration ot Domicile ~nd Citizonship in the State ot Florida that 1 am t'iling this day in aeeord~nce. a~d in
eonformity with Section 222.17~ Florida St~tutes. • ,
1 was (ormerl a legal re~ident ot n L~/ q~~'~R ~ T/ ~ ,'~y~ ~ and I
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residcd at ~~35 ~E~Y~/~-7~ ' However. I have cbanged my domicile to
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aad am and have been a bona Gde resident ot the State ot Fbrida since 6'' r ~~1 day o[
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.19 - and I nside at ~.t_l
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(St~t and Number)
~ f!~~ CC`- ST . L UC I E County. Florida,
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~nd this statement is to be taken as my declaration of citizen~hip. actua! legal residence and domicile in the State ot filorids.
IF fOR THE PURPOSE OF ~NROLLING IF FOR HONESTEA~ PURPOSES~
CHII~REN IN SCHOOL~ PIEASE STATE PIEASE CHFCK! ~
THEIR NAMES:
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ROCER Pp~j~,~S
CLERK CIR~UIT ~pURT ~
PCrry ~ Y£R~F~ED
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Ij I FURTHF.R CERTIFY that I will register at my local address when the registration books reopen, and comply with all
~ other requircments o[ a legal resident of this State.
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; I FURT1iE~ ~ERTIFY thr.t I have no intrntion to return to my formcr domicile, and I intend to remain in
t jT~.,f"/E~' CE . $T. LUG 1 E .County.
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~ Florida. permancnti, .
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' Sworn to and subscribed before me this ~ day ot -/~L R«- + FL~ , ~ ys~
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~ ROGER P01 TRAS~ CLERK OF C IRGUI T GOURT
ST. LUCIE COUNTY, FLORIUA ~
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BY •
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t EPUTY LERK
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~ . ~~AK 292 P~~ 909
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