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HomeMy WebLinkAbout0268 Deciaration of Qa~~ic~te and C~~iz~nship TO THE CLF.IiK OF TNE CIRCUIT COURT. sT . ~ uc ~ E 416'739 COUNTY. FLORIDA: This is my declaration ot Domicilo aed Citizenship in the Slate ot Florida that I am 5ling this day in accordance. and in eontormity with Section 222.1T. Florida Statutca. I w as formerl a legal msident ot ~a~NEs i 6iE' , f j,L„~ aad I _ ICityl 1Stat~) resided at ~t2.-Lv L~1~. .~lowever. I have changed my domicile to (Str+et and Numpe~) and am and have been a bona fide resideat ot the Siata of Florid~ since h' e~ E~7 day of SE%'7~ ~~t~~ .19_._Z,a~. and I reside at ! 7 S~~ VE S T,~ii<~~.u ~ i. (Stieet snd N~unberl r'~i. si. ~v~~E ST. LUGIE . County. Florida. lGt~) , and this statement u to be taken e~s my declaration of eitizenship. actual legal re~idence and domicile in the State ot Florida. IF FOR THE PURPOSE Of ENROILING IF FOR HONESTEAD PURPOSES~ CHILDREN IN SCHOOI~ PLEASE STATE PIEASE CHECKI r-'~`-} THE IR NAMESt L~~~'~ m? ~ t/t i~~- ~~LL ~7fr'u,~) ~,~"~7 s /~sILL ~ ~ ' FIlEO AND RECO~UEi ST. LUC~E COUNT~ F~R FCC= ~ POITRAS ~ . :Cll'T C~.: ' . c;: S:F 11 8 4~ AN'1R ~ ; i _ 416'7:39 ~ , ~ I FURTt1ER CEftTIFY that I will segister at my.local addmss when the registration books reopen, and comply with ell ~ other requirements ot a legal residenl oi this State. . ~ i ~ I FURT116::t CE:ttTIFY lhat I have no intcntion to return to mv former domicile, ttnd I_ intend to remain in ' s---- - i ~ T. U C I E . Couniy. f ICitJ) . ~ Florida, permanenti; . . - " ~ ~ ~ s a ~ ~ f OuN T~ . y J~ ~/O ~ ~ G~~ , ~ 7~ ~~~7 ~ d= . 1 . - v `p~y: oQ- ~l /jl f,Jl~Lils ~ SJ~'•~~~o~~E.••' IName) ~ ~?4/F CO~N~+~ c ~ 17S? v~~if//~vr,i ~ j, (Addres~) ~ Sw•orn to and ~ubscrihed b~forc mr this•__ day o( . S i. L,,~i r~~ 7 ~ ~ ~ . A.U. 19. 7 O ~ ' RQGER_P _I_TRl.S,_ Cl,FRK CF C IRCUI T COU~T - _ ST . L UG I E COUisTY, F LO:t t UA ~ w~ ~ aY: u '£PUTY LERK ~ ~ ~ F; i < - : ~54 F~~~ ~f ~ ~ S ;F'. . ~ _ . _ ~ _~o->a a~~ y~ . ~ " I ~ .f~- ~ /`s` a~"-", "'~v~~~~z~.~LS~ _ ~t:F,`"%.. , . _ _ _ _ 'c ti_.. .'~zv~:~+:-,.~.'~ Y ~