HomeMy WebLinkAbout2559 Declaration of Domicile and Citizenship
TO TIIE CLERK OF THE CIRCUIT COURT• .
ST.' LUC I E - OOUNTY• FLORIDA:
Thb V my declaration of Do~aicik and Citbmnsbip la the State et Florida that I aa? tilias thM day in aceoedanos. and iA
conformity witb Section 222x7, Florida Statutes.
SE rN ~ LJ. C/A . and I
I was former a b6a1 resWsnt of -
Ipy) l8tate)
reafded at X ~ - -However. I bave changed m,~r domicile to
- I~t asi Nr•!~r)
and am and have been a bona tide resident o[tbe SWe of Florida siaos = 3 /QD_ day of
Tg N u R ~2 ~ ,19
mil!
_ and I reside at a ~o .S Cc~ tf A o A n! d F. .
18tr«t aad Hawb~el
pa QT ~T c-c c. E = ST. LUG I E County. Florida,
IC141
and this statement is to bs taken as my declaration of dtissnship. actual bgal raidenoe and domicile in the State at Florida.
If.fOR THE PURPOSE OF ENROLLING i~f FOR HOMESTEAD PURPOSES,
CH 1 t.DREN I N SCNOOt., PLEASE STATE PLEASE CHECKt;
THEIR NANES2 .
FILEQ AND" R'E ~
ST. LUCK COU~~
_ - G= CORD VERIFIED
_ _43.1.2'"1
'79 FEB 6 AM I1: 30
9'~ ~
. - RUUCP, ~OtTR..S
CLERK CIRCUIT COURT..
I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and oomph with all
other rcquirements of a legal resident of this State.
i
f I FURTHER CERTIFY that I have rw intention to return to my former domirik. and I intend to remain in
i ~ .County.
lay) - - -
Fbrida. permanentt; .
-
COUNTY _
.-1~_.
o ~ ~
~~/E T ShFAtd Ut
c `rJ' •~'~C_.)0 ai ~~J' Off` - -
IUC~f COUq+~ E~ INS)
a 3~ sw ~k~P~R~ Amt .
- u?ddns) -
Sworn to and subscn'bed before me this ~ day of . ~ ~ ~
~ ~ ~c -r t - L A
-
3
RQGER P01 TRAS, CLERK OF CIRCUIT COURT
ST. LUG I E COUNTY, f LOR t UA
BY: .
EPUTY t.ERK
~ • - ~ so~~ X2556
. , ACO Form 71 Y2
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