HomeMy WebLinkAbout0353 Declaration of nomicile and Citizenship '
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TO TllE CLERK OF T1iE CIRCUIT COURT~
ST~Ll1C I E (AUIVTY. FI.ORIDA:
TUis is my declantion ot Donricile aad Citi:eruhip ia the Stste ot Florida tluit I am Gliag ~his day it~ acootdaaee. aed in
coniormity with Seclion 222.27. Florid~ Statute~.
~ was formerl a legal reaideat oi ~naurao•++ _ , T~c_a ~ - aad I
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310 £nf i eld Lane . Nowever, I have ehu?ged my domieik to
lStn~t ~ad NomM~)
and ua ~nd have been a boa? fide resident of the State of Florida ~iaes 9 th . day oi
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i'ebruary_19 79~~adIresideat 154 Piverview Drive
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Jensen Beach ST. LUG I E Couuty. Fbrids.
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and this statement is to be taken as tny dectuation oi eitizenship. aetu~l kgal reaideaa aad doanicile in the State ot Florida.
• If.fOR THE PURPOSE OF EltROLLING IF iOR HOMESTEA~ PURPOSES~
' CHILDREN IN SCHOOL~ PIEASE STATE PLEASE CHECK: ~
THEIR NAMES.
ICelsey Lynn Polzin F1LED AND RECORDE~~
tt;Cl~ C~U`ZTY. FLA.
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i I FURTHER CERTJFY that I~viq register at my bcal address when the registration books reopen, and eomply with all
oLher requirements ot a legal resident of this State.
i I F'URTHFR CERTIFY that I have no intention to return to m tormer domicile. and I intend to remain in
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Fbrida. permanenti; .
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" Sw orn to and subseribcd before me this ~ day of - ;
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~ ROGER P01 TRAS, C RK OF C IRCUI T COURT }
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ST. LUGIE COUNTY, FLOR A ~ ~
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EP Y LERK ~
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