HomeMy WebLinkAbout2478 claration of L?omicil® and Citizenship ~ ~
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. ~ 433063
TO TI!)r CI,>rRK OFTIiE CIRCUIT COURT, -
ST. LUG 1 E __-COUi+1TY, FLORIDA:
Thin is my declaration of Domicile and Citizenship in the State t F1orWa that am f ' thta day in accordance. and in
conformity with Sectan ?22.17. Florida Statutes. .
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I was t~r~l~ s legal resident ~ I
r
resided at However. I have changed my domicile to
Niuober)
am and have n a bona rde resident of the State of Florida mace _ day of
i and I reside at ~
$7~ ( sad Nnenbet)
~ C ~ ST. LUC 1 E County, Fbrida,
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and this atateraent is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
IF fOR THE PURPOSE OF ENROLLING If fOR HONESTEAO PURPOSES,
CHILDREN IN SCHOOL., PLEASE STATE PLEASE CHECK:
T IR N NES:
an p~ ~a . d~
• - ' FILED'AN9 RE-0~ -
ST. LUCIE COUNTY.
-433063
'19 FEB 6 AM 8 . q0 ~
-
ROGER PQITR:~E
- CLERK CIRCUIT COURT,
I FURTHER CERTIFY that I wdl rrgister at my local address when the registration books reopen. and comply with all
othcr rcquirements of a {egal resident of this State.
~ I FURTHER CERTIFY that I have no intention to rcturn to my former domicile. and I intend to remain in .
• ° L U C i Er ~ County.
lC+t~l
E Florida. permanents;.
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- ` ~ _ (Address)
Sworn to and subxcribcd betoro me this day of - -
- .
f
_ A.D.19_ 79 i
ROGER P01 TRAS CLERK OF G 1 F2GU I T COURT .
ST. LUG1 E COUNTY, fLOR i A
BY:
EPUTY LERK ~ q ~Q
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i AGO Form 71 22