HomeMy WebLinkAbout0392 Declaratican of Domicite and Cit~zenship
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TO THE CGERK OF THE CIRCUIT COURT. ~
ST. LUG I E CoUt~'~'~r. FLORIDA: ~
This U my declaralion ot Domicile ~ad Citizeaship in the Stete ot Ftorida that I~m CGng this day in accordance. snd in
eonformity with Section 222.17. Flor'rda Statutes. ~
I wu [ormerl a leg~l resident ot , f~C.~~P1ti'.b. . ~L'r' K% 7~ and I
• (Cit~l (3tatel
ce~ided at 9/ ~iti I . Howevar. I hsve ehaaged my domicile to
. lStreet ~nd NIumbKl _ /
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and am and hsve bcen a bona Cde resident of the State af Florida aiace ~ day oi
f ~ ~z"/~i ? ~ i,~ ,19. ' ' . and I reside at . _~L• 7 ~ ! rY~F ~ ~1 1C~ -
(3ere~t u~d NumEar)
' ~ ST. LUGIE ~
~t K~- y t I_ ~'C ~ , Couaty. Fiorida,
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snd this statement is to be taken as my declaration of citizenship. adual legal ne~idence and domicile iu the State of Florida.
If FOR THE PURP4SE OF ENROIIING IF i"OR HOHESTEAD PtfRPOSES~
CHILDREN IN SCHOOL~ Pl~ASE STATE PLEASE CNECK~ ~ ~
THEIR NANES:
_ - - -
~ - f14E0 AN~ RECQRDED
C/-}t{~ ~P ~~fi~1n.,Z~~.:.- #Z.: r~i-_~ St.IUCIE COUNTY flA.
F4CEA DOITRAS /
i9~ !tt ~~_c?K ~ =CUiT C(`=' 1~
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I FttRT1IER CERTIFY that I will re~ister at my loca! address when the registration books reopen. and compiy with s8
~ other mquirements oi a tr~ai resident of thu State. ~
` I FURTHF.Z CERTIFY that 1 have no "sntrntion to rpturn to mv tormer domirile, and 1 intend to remxin in
~ , 7. U C i E . County.
(Citr1
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i Florida, pcrmanenci~.
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Sworn to nnd wb,crit?rd b~torc mc this day ot rt' ~ y~. L_j,
a " A.ll. 19. 7 ~ ' .
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~ ROGER __01 Tf?AS,_Cl.ERK OF, G IRCUt T C.Ol~2T
~ ST. LIJC I E COUNTY, FLOit 1 L'A
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~ ~ Y~~ R Y ~A~~ 392
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