HomeMy WebLinkAbout0134 . Q~ciaration of~ Domiciie and Citiz~nship.
416665 .
TO TIIE CLFRK OF TtIE CIRCUIT COURT.
ST. Ll1C I E COUNTY. FLORIDA:
This is my deciaration ot Domicile and Citizenship in the State of Fiorida that I am Clin~ thu day iA accocdance. a~d in
conformity with Seetion 222.17, Florida Statute~.
I was to~merlY ~ legal resident ot ' ~~~y 1~ ~ and I
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resided at ~ . However, I have changed my domicile to
IStreat aod Num 1
and am and have been a bona Cde resideat of the State ot Florida since ~ day of
.19_? a. and I reside at ~a~
IStnyt snd Number}
- ST . LUG 1 E County. Floride.
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and this statement is to be takcn as my declaralion ot citizenship. actual l~gal re~idence aad domicile in the State of F'lorida.
IF FOR THE PURPOSE Of ENROLIING IF FOR HONESTEA~ P.URPOSES~
CHIIOREN IN SCNOOI~ PIEASE STATE PLEASE CHECK:
T H E i R N A N E S:
FIIED ANQ REC~IR~E,
ST.IUCtE CauNTY Ftk
, AO;,EF =O+TR+S
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S« I I 2 4z PH'19
416665
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; I FURTIiER CERTIFY that I will regisLer at my locai address Khen the registration books reopen, and coinply with all
s other requirements o[ a Icgal resident of this State.
S
~ 1 FURT1tE.t Ch:RTIF1' thtt 1 have no intc•ntion to rFturn to my t~rmer dom:cile, and 1 intend ~to remain in
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~ F'lorida, pcrminer.t,i;. -
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ROGER P01_ -2~5~ CI_ERK OF C IkCUI T COlk2 T
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ST. LUGIE COUNTY, FLORIUA
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