HomeMy WebLinkAbout1194 r
4:30432
.
TO Ti1L CLI:HIC OF THI'. CIKCUIT COURT. {
ST. LUG I E COITNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am tiling this dsy in accordance, and in
conformity with tiection 222.17, Florida Statutes. /n~ i
i'Y~1~ ~ t ~ and l ~
I wss lonncrl a Icgal resident of ~ iSlate)
ICity1
resided al ~ X ~ ~ ~ - ~ ~ • Ifowover, I have changed my domicile t0
- (Street sad Number)
and am nd have Lecn a bona fide resident of the State of Florida since
J ' / ~ -y~ yam'
,19~. and I reside at
(Street and Number)
~ ST. LUGIE
D ~ ~ ~ County, Florida,
lCit~) '
and this statement is to h: taken as my declaration of cit'venship, actual legal residence and doauci:e in the State of Florida.
- i
F FOit THE PURPOSE- OF E~lROLL ING I F FOR HOMESTEAD t'URPOSES~
CHILDREN IN Sf-HOOL~ PLEASE STATE PLEASE CHECt'.:
HEIR NAHES:
- - :.".u REGORGED
~ : _ _
430432
. - - 9~ ~
- ~
I FURTHER C1:RTIFY that T will register at i*sy local address w}:en the m6~stratien basks reopen, and comply with rl!
ether requirements of a Iegal resident of this State. -
9 I FURT}iE;t CF.RTII'Y that: T h.~.e no intention to
rn~ tu~to my former de_micii+, and I intend to remain in
~ - _ - - ~ Y U C t E . (:aunty.
icily)
F'lo:ida.l>crmanrn~i;.
F
_ j1_
x
_ `
_ F
f
y
• : % ~
e ~ ~ `
~ ~ ~
r~ - J - r+~ i
'u ~s~~ / / (Name) -
.
~ (Address) }
= S,•.•nrn tr, atcd s.uif«ritic•d hcferc me this _ day of ~ i
- - A.P. l'~-~~ ~ ~
- ~ , ~ - c~ C11I COl~2T
S'f : 1_i1G I C Cntlivi-Y, F t_(`,'c t Ulf ~ -
_ ~ ~ I I: ft K ~ ~ 301- ~:=1189 ~
Y° _ - - ~ - . _ - -