HomeMy WebLinkAbout2968 431541
TO TIiN: CI,iatK Oi~' THE taitCtllT COURT.
ST. LUG I E COUNTY. E'LORInA:
This Is my declaration of nomicilo and Cilixenrhip in the State of Florida that I am filing this day in acconiance, and in
conformity with Scelion 222.17, Florida Statutrs. ••~n
ana~e.•..rr,r ~ ~ - and I
1 was tormerl a legal resident of IState) ;
lCi~y)
resided at . Ilowevrr, I have changed my domicile to
(Street and Number)
- ' - ~3 have beast a Haan tide resident of the State of Florida since day of
oi,,, an, au .J
.19.~.. and I reside at _!K~ h _~«~bq - t
(Street and umber)
` ` ST. LUG 1 E County, Florida,
lCit~)
and this statement is to he taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
I F FOR THE PURPOSE OF ENROLLING I F FOR HOMESTEAD PURrP-,~E-S~r
C111LDREN IN SCHOOL, PLEASE S1 ATE PLEASE CHECK: 1 '
'
THEIR NAHESi
FlLi=O A!~ID FtECORDEO
431541
- - '79 JAS'. 22 AN i i : 47
'
- ~
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this Slate. {
' I FURT1iE:t CERTIFY that I have no intention to return tom former domicile, and I intend to remain in
U C 1 E _ ,County,
' (City)
Florida, permanenti;. ;
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1 j 0 ~~l t'i ~ /ice
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• ~
'jam ~'•.~s o~ (Name)
O
v~en.~~ (Address)
Sworn to and subscribed before me this ~ /y day of ' ~°a" ~ 4
ROGER FO I TRAS,~CLERK OF G f RGU i T COU:T - `
t
ST. LUC I E COUtdTY, FLOR i UA
BY: -
EPUTY LERK s~ ~+e~
60CI(3U1 ?~r~~9UJ
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