HomeMy WebLinkAbout0049 _
' iie and Citizenship - ~
Declaration of Dom~c
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4,x'7844
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TO THB CLTRK OF THE CQ6CUIT COURT. ~ _ - ' ,
• ST. lUC 1 E CoUr1TY. FLORmA: ~ ~
• ' This b aq? deeLratia+ of Domkile and Cititeaship tM State of Florida that I am ~i this dq la aooordaoa. and in
tootormiq with Seetioa 222.17. Fbrida StatutN.
~ e~~ A e v ~ e t d'~ G-y o,o and I
I was i rn+erl a kEal raideat of IC~i1 Isw.1
tesidsd ~ Noe~.r1 Ilowwer. I haw ebansed ~r~ ~
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1&eMtasi
and am snd have been s bona tide resident of the State of Florida since
Vl_7DAc~Q -19..2. and I reside at 3 ~ 1~ S . i1 S'S.=fir ~~~~lF -
_ - tgtnet atl Nr•~l -
~ La ~ t F ST . LUG 1 E County. Florida. .
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and this statement is to bs taken as my declaration of eitizenihip. actual ~ tesidenoe and domia7e in the State of ~Flaeida.
Ii iOR HOMESTEAD PURPOSES,
Ii- FOR THE PURPOSE Of ENROt.t.INa ~ pt,EASE CHECKS
CHILDREN IN SCHOOLS PLEASE STATE
- THEIR NAMESS
4;z'7844
'78 (t~C 18 PFi 3:49 i
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rat my beat address when the regLstrstlon ~s reopen. aad comPb with sll
I F~ CERTIFY that I will registe
other requirements of a kg:l reaideat of this State. -
I FUIt'PHER CERTIFY that I have no intention to return to former domicile. and I intend to remain in
~T . L U C 1 E - County.
~ 171 .
Florida. permanenci; .
A e /e.
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Sworn to and~subscn'bed before me this ~L~_-~- day of
.A.D.19.~8
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ROGER POITRAS CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, fLOR1UA - ~ - -
BY:
_ EPUTY LERK
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hG0 Form 71
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