HomeMy WebLinkAbout0934 , D~ctaration of t3omicile ana ~~~~zen5~~~~ ~
~ ~ ~
~ . • ' 4.i.s3s .
~ TO TtiE CI.ERK OF THE CIRCUIT COURT~ . s,
M . ~
' ST ~ L UC I E CQUNTY, FLORIDA:
TAta b my decla~atioa oi Domtcile ~od Cit~caship in the St~te ot Flo~tdR tlut I am Cding this day in aecordaare. ~nd in
tontotrttitr with Settion 222.17. Fbcida Statutes.
I Mas torm~rl • kgal reaident ot 1~ ti' J ~ ~ s e Y and I
ccur1
resided at ~ ~ ~ ~ ~ ---lz ~ e . Howsver. I bave ehanged my domicilc to •
. (9trMt wd NnmOa)
~nd am and h~ve been a boaa C~de re~ident ot ti~e State ot F1o~ida since dar ot
c~ ~ 19_~., sod I reside at ~ C ti L•-~ S r e~
~ r (Stnet u?d K~aoset)
~ ~ ~ n~~ h~ c., t~- _ ST . L UC i E County, Fiorids.
~ (c.~t~1 '
and this stateinent is to be takea u my deelsntion ot citizen'ship. aetual kgal nsidence and domicile in the State ot Florids.
IF FOR THE PURPOSE OF ENROLLlNG If ~OR NONESTEAD.PURPOSES~
CHII~REN IN SCNOOL~ PtEASE STATE PIEASE CHECK2
• ~ THE IR N/tHESt
, .,,JY1 ~ i. l ~ ~ ~ ~ T ~ l .
~ ;~lZ ~Ir1 -
: ~ ~ ~ -Q- ~ ~ ?~.2 t~ . ~1 ~ ~~Y~1 ~1 ~~A
. ~~~s ?oitA~;
C'_fPK.~,~.:~p~ COUR~
. . 1 •
pl:~ ly rM ~ r~' t
415i.~~
I FUIt'TIiER CERTIFY that I w~l register at my local addces+ when the registration books reopen, and comply with aU -
other requircments o! a Icgal residenl of this State.
I FURTIIE:2 CE1tT[FY that I have no intention to return to my former domicite, and I intcnd to remain in
• S T. L U C 1 E _ _ County,
ccnr~ -
Fbrida. permanenti; .
" ~~~~1.x~
~
~ ~,:~•ry
U .tJ ~ i~ , ~ !
~ : . - ~ ? ~ ~ ;
I U.~ 1_-' -e• ~ 1
• J•: . ~ ~1 ' ~ ' } t c~ < <c
~G~;~`:.:..:.-.~'~~~ , r ,r ~ (Narn.) _ t t
, i.f:'..' ~ ~ 4~ i C S'Q ~
tI J~1 ~ ~ YJ ~ S l ~C ~ ~ ~
. ~ ~ (Addrea~) '
Sworn to and suhscribrd betore mc this ~ 9 day of ~ ' e f'~Y
~ A.D.1J. 7 8 3~`( S~-
FOGER PO 1 TRAS. CLERK OF C IRCU I T COUtT ~
ST. LUGlE COUNTY, FLORIUA ~
. ;
BY: ~ ~
. ,
EPUTY LERK , ~
VV~/ , 1
' ~ JO~I ~ PAGE _ ~
AGO ~orn~ 71
"
- ~ - - - - ~ ~ . ~ - -
~dti 'a,~"G°-,-~.- ' T : .
: . . , . ~