HomeMy WebLinkAbout1766 C~~~i~~~~~~n ~f ~c~rn~~~~~ and ~~ti~~~slh~~ ~
- ~ 43Z58S
TO T11E C1.F:1tK OF TIiF. CIRCUIT COURT. ,
ST. LUC I E ~ COUNTY, I~'LORIDA:
This is my declaration of Domicilo and Citizonship i~ the Stale of Florida that I am Cding this day in accordance. and in
conformity with Section 222.17. Florida Statutes. -
I was formed a legal resident of Gui lder land ~ N ew YoYk and Y
----x ICit~) IState)
rrsided at Stag
Firm Road ~ R.D.#1 _ . However. I have changed my domicile to
(StnN and Plumber)
and am and have been a bona fide resident of the State of Florida since 23rd day of
August .1975 - _ and I reside at ne
(Stroet and Number)
port St . Lucie ST . LUG 1 E County. Florida..
late)
and this statement is to be takes as ,ny declaration of citizenship. actual legal residence sad domicile in the State of Florida.
IF POR THE PURPOSE Of ENROLLING IF FOR NOMESTEA4 PURPOSES,
CHILf)REN IN SLHOOL, PLEASE STATE. Pt.EASE CNECK:
THEIR NAMES:
FILEO=ANO RECORD
. - ~?..i.UCtE COUNTY.~~L`A:'
- f r~~43 ~I
• '79 FEB. I AM t0 ~ ~ 9
q
- rrJ;:E.R. ?OfTR~S
CLERK CIRCUIT COURT
.
I FURTHER CERTIFY that ill register at my local address when the registration books reopen, sad comply with aU
~ other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
k - J T. L U C t E County.
ICar) -
Flonida..perma~
enti_{'•
~~?~~i iii ~ f s~t~/%j~~i
w.r 0
.f ~'.9
i,~:; -
,rte ; IN )
a
Sworn to end subscribed before mo this __.1___._. daY of
9 .
d ~ A.D.19_ ~ 1
ROGER _P01 TRAS. CLERK OF C IRCIII T COURT
ST. L IE COUNTY, FL -tUA ~ - -
BY: c gflGKt~~ '::'~`1~~
EPUTY I.ERK ~
•
. 1