HomeMy WebLinkAbout0075 t~eciar~tion of Dornici~e and Citix~nship
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LtJC I E CpUNi'y, FLORIDA:
T~is is my declaration ot Domicile ~nd Citizonship in the State of Florida that 1 am Cding this day in accordance. and in
eontormity with Section 222.17. Florids Statutes.
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I was tormerly a legal nsident of
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residcd ~t ~-5 5,L a~~Y . Nowever. I have ehanged my domicile to
(Street aod Numbsr) •
and am an~ have bcea a bona fide resident of the State of Florids since ~ ~ day ot
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~ ~ 19 ! . and I reside at ~j/ ' ~~1~~ ~ ~
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(3treet and Number)
/ ' ST. LUCIE
,~G~ ~ ~ C- ~ i , Councy. F?oriae.
ICit~l
and this statement is to be taken as my declsration of eitizen~hip. actual legal residence aad domicile in the State o[ Florida. ,
IF i'OR THE PURPOSE OF ENROLIING IF' FOR HOHESTEA~ PURPOSES~
CHIL~REN IN SCHOOI~ PIEASE STATE PLEASE CHECK: ~
THEIR NAHES:
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FILEO ~MD RECORDEU ~
~ , 3 . ST. WCIE COUMTY FLA.
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~ SEP I I IZ 31 PM''8
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I FUfiTIiER CE:RTIFY that I a•ill register at my locel address when lhe registration books reopen, and comply v?~itfi sU
~ other requirements of a legal msident of this Statc.
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€ I FU~tTIiF:~t CE:RTIFI that I have no intt-ntinn to r~turn t~ my torm~r domicile, and I intend to remain i~~
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S J T. L U G 1 E , County.
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~ Florida, prrmanenti;.
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~ ROGER P01 T~2AS CLF;RK Or C IRCU I 7 COURT
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