HomeMy WebLinkAbout0843 _ Declaration of Domicile and Citiz~nship
41.8~
TO TlIE CLERK OF T}IE CIRCUIT COUIiT.
ST. LUC I E CpUNTY. I~'I.ORIDA:
This is my declaration ot i)omicile and Citizenship in the Stato of Florida that I am C~tiag this day in accordance. and in
contormily with Section 7Z2.17. FloridA Statutcs.
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I wns formeri a legal resident ot . i~~?~f _ and I
ICity1 lSta 1
rrsickd at 4' 3 2 ~-~L~ . However. I have changed my do~nicile to ~
lSlreet and Numberl
and am and have been a bona Cde msidcnt ot thc State of Florida since I day ot
.19 ~ ~ . and 1 reside at ..T
/ ~ ~ ~.~L~zd-v~
~ i tStreet and Numbe~) .
. ST , l.l1C I E County, Florida,
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and tAis statement is to be taken as my declaration of ritizenshi~. actuaf legal residence and domicile in the State of Florida.
I F FOR THE PURPOSE OF ENROLL 1tiG I F FOR HOIdESTEAD PURPOSES~
CHILOREN If7 SCHOOL~ PIEASE STATE P~~ASE CHECK: ~
THEIR NAMES:
FIlEOItNG REC~~tUf~?
St. tUCtE COUNTY Ft~1. ~
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0~' 3 9 3o AH'78
418932
1 FUR"I7JF.R CERTIFY that I w•ill reRister at my local addr~ss when the registration boo!cs reopen~ and comply with all
othcr requi*ements of a Icgal resident o[ this State. ~
I FIJRTHF,:t CF:RTIFY tAzt I hxve tso intrntion to return to m• forn~cr domicite, and I intcnd to mmain in
T. - U C 1 C . County .
(Cicy! _
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Florida, perman~n~i; . . ~
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Svrorn to and subscribc~d beforc me this day o! ~~~~j
- . A.0.19. 7 ~ ~
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ROGER PO I TFtAS,~ CL ERK OF G 1 RCU I T COl~2 T . .
ST. LUGIE COUNTY, FLORIUA ~ ~
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BY: z.
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EPUTY LERK
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