HomeMy WebLinkAbout0803 r ~
De~lar~tion of Domicile and Citizenship
~ ~ ~.889~
TO TIIE CI.ERK OF THE CIRCUIT COUR't. ~
ST. lUG I E CpUNTy. FLORIDA:
Thw Is my declaration oi Domicile and Citizanship iri the 5tate ot Fbrida that I am Ciling this day in accordance. ~nd in
tontormity arith Section 2~.'.17. Florida Statutrs.
I was t4rmerlr a legal resident ot %J~y~~~/'I . ~~r ~ and I
resided at 1 C~ 1 ~~~~i11 /~,'=/~JL~ ~ tCicrt ts'tat~) -
. However. I have chaaged my domicile to
(3treet wd Nuwhad ~
and am and have bee~ s bond C~le resideni of the State ot Fbri~a since ~ g~~ day o[
l9 and I reside at ~
D`/5 -S ~t, yra~,~~Ay C/k1C'C[
f lstreet ~nd Number) -
~Q~!~~ ~ U C~ t
l ~ ST. Lt1C I E Cou~ty, E lorida, _
lQt~l
and lhis statement is to be taken es my deciaration of eitizenship. actuai lega! residence and domicile in the State of Florida.
IF i'UR 7HE PURPOSE OF ENROLIiNG IF FOR HOHESTERD PURPOSES~
CHILDREN iN SCHOOL~ PLEASE STATE _ PLEASE CHEtK: ~
THEIR NAHES:
~I~%H[ CL-~tl /j~ D '~t1 L /L L
//I/<K ~~9 ~~,G'~:7~ C. .
~~fi0/k`~ ~l . [,~%%(~L/C L iT.l CIE COUNTT FLA. .
- ROCE~ POt~~iAS
~1~i~L)2. f . Q;U~~C(.- c~Fa~. ;:,,_ca~ c0u •
~rrn- . r.
Oct 3 ~
~8 3s AN'~8
~ ~18895
I FURTIiF.R CERTIE'Y lhat I wilt register at my locat address when the registration books rcopen. aced comply wilh al!
other ~rquirements of a legal re~ident ot this State, ~
F
I FURTHE:~ CF.RTIFY th~t I have no inte-nlinn to return to my former domicile. and I intend to rcmain in ~
r~ ~ b,j.~ . ST ~ U C f E . Coiinty.
l~t11 . -
Florida, permanenti,. ~
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Sw•vrn to and subscribrd tx furc me this day o( ~ S l ~ UC/~~ E~o/t~DA 334~5"Z- ~ ~
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-1.LL'~N . A.D.19. 7 C~
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ROGER POIIRAS CLERK OF C~RGUIT COU2T
~ ST. LUC I E COUNTY, f LOk 1 UA ~
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EPUTY LERK ' ~
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