HomeMy WebLinkAbout0530 Declaration of Domicile and Citizenship c. f'
433`79~
TO TIIE CL~iK OF' THE CIRCUIT COUR'P~
ST. LUC I E COUNTY. FIAAIDA:
Thts !s m~? declustion ot Domklle aad Citisenship ia ths Btate ot Fbrida tbat I ata Gliag LAis da,p ia aooordanee. and iA
~onttormity ~vith Sectiou 222.17. Florida Statutes. ~
~~i7~i./i~~ = ~~'1~h~~r~~.,~ andI
1 wa to~ s kgal resideat ot it~1 19uu1
resjded at .~%r ~!~~L~~~`~•~'~ - Hwvever. I Uave e6an~ed my domicile to
l8ttr+R 4d Ndeb~N -
~ i111 ~11a I1~11e ~EOq i bOlli rld0 leEll~EOl OI LI1Q S~iLe Ot F~IOf~a i~llt0 ~I T~I ~ ~ g,~ dty 0~
,19 - aad I re~ide ae ?y /~c /~ii~
1&twt ~d NnmbKl
,~,+f S'f L.~ci,•t ST. LUG I E Couac~. ~9orida.
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u~d this stateaneat is b be taken as nq? dec4ration ot eiliLensbip. attual legal resid~nos and domieile in tbe State of F'lorida.
• IF•FOR THE PURPOSE Of ENROLLING IF iOR HOMESTEAD PURPOSES~
• CHILDREN IN SCHOOL~ PLEASE STAT~ ~ PLEASE CNECK: ~
THEIR NANESS • .
Lo c.~:D RECOR~Ed'
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I FtJRTNER CE~tTIF1f thaL I wtq reRister at m~ loca! address wrhea tbe e~egistratioa books t~eopen. s~ oompy ~ritb all
4 olhcr requiremeats o[ a lega[ resident of lhis SLate.
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; I FUgTNE~ CEBTIFY thst I luive no intention to return to m former domicile, and I iatend to nmain in
; •y~.,---- ~ . . ~ . ~ County.
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Fbrida. permaneati; .
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~ Sworn to and subxribed betoro me tlw da3? ot 1_ ~
~ '
~ _ A.D.19_ 79
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~ ROGER P01'TRAS. CLERK OF C i RCU I T GOl~2T ;
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~ ST. LUC I E COUNTY, f ~OR 1.UA ~ '
~ . .
~ BY .
~ EPUTY LERK
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~ ~ 600lc W~7 P~CE 5~,~7 ~
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ACO Fntm 71 22
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