HomeMy WebLinkAbout1637 ' ii # + nd Citizenshi ~
Declaration of Domic e a p
.TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUC I E COUNTY, FiARIDA: -
This is ~ declaration of DomkDe and CIti:snship in the State of Florida that I am Nta3 this day is aeoordaaoe. sad is
conformity with Seetioa 228.17. Fbdda 8tatutss.
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I was i nner a legal resident d ~ -fin c~ ~r~lZ1 ~ - ~ • ~ L-l Ci~_ sad I ; -
lWt7) (Stn
Q ~_o~ C'~~~r..~ N~ a 1 Ll S' 7 - However, i have changed my domicils to
resided at ' `
. (Stank aaa Ns+aesrl~_r ~-k.- -
sad am aed have been a bona &le resident ~ the Stat+~ of Florida since ~ ~ ~ o~
19~. sad I aside at ~ ~ ~ ~ S W ~ e"~N t~0 ~ ~
{Qr ~ n ~ u
. lBteMt sed omba)
17? n ~ 1 \ ~o? n'~' _ ST . LUG i E 'County. Florida. 1
IG41 Y
sad this statement is to be taken as my dechration of dtiunship, setual legal residence and domidle is the State of Florida. .
IF POR THE PURPOSE Of ENROLLING IF POR HOMESTEAD PURP03ES,
CHILDREN IN SCHOOL, PLEASE'STATE PLEASE CHECK:
-T~HyEIR NANESS
~I10 M c1 ~ ~ \_Q ~M t ~ ~Y1C0..).AS'
.F?i_EO aND RECORDED' s
~L -~ph~ '\~~~^~5~~ ~~JC~E COUNTY, FLA.
- 434.4'76
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. - '79 FE8 19 PM ~2 : i 3
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I FURTHER CERTIFY that I will register st my local address when the registration books reopen. and Damply with all
other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have m inteatioe to retnra tom former domicile. sad I intend to remain in
, U C 1 E County,
lClt,~l _
Fbrida, permaaenti,•. .
~ tjOUNT
V~ .BOG ~~l~ L~.a ~ ~ ~ 4 ~t p e a 11 ~
ac _ : ~
:
~ , ~ y y S ~.J lee n~ wove Q.u-c_
'f ~CONiY. Q~ _ 1 t ~ w. ~ fie,. . ~ Y ~ -
(AdderN)
Sworn t0 and subarn'bed before me thu _!___L_- dal d .y ~ ~ ? t .c~~' ~ - .
A.D.19 ~ 3y.~
. 79
ROGER P01 TRAS. CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, FLOR~oA -
BY: ~ i
EPUTY LERK
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