HomeMy WebLinkAbout0916 , D~claration ot uom~c~~e a~jc~ ~~~~~G~~~~••N ~
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TO'1`1[E CLERK OF THE C1RCUIT COURT. ' . ' ~
• ST lUC 1 E Covtv'~'Y. FLORIDA:
• Thi~ is my decluntion ot Domic;le and Cit~enabip In tbe State ot Florida t1~at I am filiag tbts day ln ~ct~ord~nK. and in
contormitr with Section ~.17. Fbrida Statutea. • , .
nrn i(` 4_'~ and I
I was torm~rl a kgal resident ot ~Sa
Horvever. i bave chan~ a~r
residcd at ~ / Si U
ISt»~t ud N~mberl
~ ~,O / - dar a~
and am u~d have been a boaa fidc nsideat ot tAe State oi Florida aince ~
~'/~/G / ti~ i ~ ~ l~ A v~r ~ a
_ .19~~. and I r~side at (Stewt.sii Nwmeerl
ST . LUC I E coupcy, ~~a..
tcie~) ~
aad tbis statement is to ba taken u mY declaratioa ot citizen'ship. actual legal rc~idence and dami~~ S~~ °t Ffo~da'
If fOR HONESTEAD PURPOSES~
I f FOR THE PURPOSE OF ENROIL i NG p~EASE CHECK: r------~-{
CHIIOREN IN SCHOOL~ PLEASE STATE ~J_~
• THEIR NANES: _
' ~ ~ ~ i .c C~ ( ~ ~ '''t-
~T.u`UC1E COUNTY FiA.
~ 1- e . ~ , ~ IIOCEA POITNAS
~ Q t F v C~-~• pRr C?<CUIT C i~
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A~~~ 19 12 4 ~ PN'T~ -
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i a, and eom 1 with all -
~ 1 FURTHER CERTIFY that I will register at my local address when the registration books reope P 7
~ othcr requircments ot a legal resident oE this Statc. .
~ FURT~IER CERTIFY that I hsvc no intention to Teturn to my formcr domicile. snd I iatend to rema~n in
~ I ~ $T L U C 1 E Count~.
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~ Florida, permsncnti~ . .
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~ ~ (Name)
f%G/ r/~PI~P~~~ /~'iti-~/
- ~Addnu! .
~ aay ot T/~ r c. 1~~' -
a Sv?•orn to a~d sut,scril~cd t~etore mc this
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~ ROGER i TRAS_,_ CLERK OF C IRCU1 T GOUFtT
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~ ST. LUC i E COUNtY, f LOR t UA •
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BY: • " ~
~ EPUTY LERK , -
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