HomeMy WebLinkAbout0279 . Qectaration of i?omicile and Citizenship
. • . 414941 ~ ~ ~
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TO TltE CGERK OR THE CIRCUIT COURT. ~ . - ~ , ' ;
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• ST. Ll1C t E ~pUNTY~ I~'I,ORIDA:
• 'I'bis ia my dcctaration ot Domiciie and Cit~eaship in the Siate of Florld~ that 1 am filiog tAi~ dsy ta accordaace. and in
tontormity with Seclion 222.17, Ftocid~ Statutes. ~
t~?as torm~rl a kgal re~ident o~ S~' ~.1~1.~ a v~ _ ~~'.~'J r a f K- and [
~cur~ ~ csa~a
resided st Lud.~ . HoMrever. I b~ve chaaged my domicile to •
(SteeK aAd NomOed
and am and have beea a bona C~dc n~ident of the State oi F'lorida ainee ti~' ~ n~ dar ot
~'_~J~`~ ,191~, and I reside at ~7 ~_~.1~ t_ A S ~(Z ~ J~
(St~+et and NumDer)
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c n.SP ~ 1'~PC~C11 ~ ST. LUG i E Count~. FMrida,
(Clyl
and tbis statement u to be taken aa tnr decb?rstion ot citizen's}?ip, actual legal reaidence and domicile in the State ot Florida.
IF fOR THE PURPOSE OP ENROLLiNG If FOR NOHESTEAD PURPOSES~
CHILOREN IN SCNOOL~ PIEASE STATE P~EASE CHECKS ~
• " 7HEIR NANES:
fItEO ~MD RECORDEp
=T~ UICIE COUNT1r F~A.
ROCER pa~tR~iS
C! ERI( Ct~CUIt COU ~
' 'r"'-- yrG~C~ED~
~ Auc 15 It o7 AN'78
_ ~ ' 414941 .
I FURTI~ER CERTIFY that I will registc~ at my loca! address when the registntion books reopen, snd comply with aU
other requin:ments oi a tega! residenC o[ this State.
I FURTIIE;t CEItTII~ Y thst I have no intention to return to my tormer domicile, and I intend to rcmaia in
_Sen_SP r~ ~2_c~r~,~ - . $T L UC I E ` . County.
~ ~~ir~ .
Florida. permsnenti; .
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Sworn to nnd subscril?cd bc[ore mc this day ot_ ~~,~P„~,~n ~„Q,,,,,Cl 4~"1 T'
. A.D.19. 7 ~ ;
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ROG£R Pn i TRAS, CLERK OF C! RGU I T GOtJRT ~ '
ST. IUCIE COUNTY, FlOk1UA •
BY: ~ ~,,.Gc,' j4.Q~ ~
. EPU7Y LERK , ~
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AGp F'orn? 71 {
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