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 ~
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' FIlEO AND RECO~UEi
ST. LUC~E COUNT~ F~R
FCC= ~ POITRAS ~
. :Cll'T C~.: '
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S:F 11 8 4~ AN'1R
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i _ 416'7:39
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~ 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. . ~
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~ I FURT116::t CE:ttTIFY lhat I have no intcntion to return to mv former domicile, ttnd I_ intend to remain in
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i ~ T. U C I E . Couniy.
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~ Florida, permanenti; . . - "
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(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 ~
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'£PUTY LERK
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