HomeMy WebLinkAbout2472 Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT COURT.
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ST LUG 1 E COUI+ITY. ,FLORIDA:
This b a~ declaration of Domicile a~ Citizenship in the State et Florida that I am SWss this daT io aoeordana. and is '
conformity with Seetioo 225.17. Florida Statutes.
I was f a legal resident at • .~D ~ • r r J -and I f =
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resided ~ ~0 ~ o ~ . S' 1. - However, I have ebanged apr domicOs to ~
(8tnst aat NnoMel.
and am and haw been a bona fide resident of the State of Florida sines ~ ~ ~
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~ybr~ r4 .1f.2~, a~ i reside at .T/. d / ~io ~Lc i'1 i Q d P t
PO s7. L. `c J P _ ST. LUG i E Coun4. Florida, #
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:nd this statement b to be Wien as my declaration of citizenship. actual legal residence and domicDe in the State at Florida.
IF POR THE PURPOSE Of ENROLLING IF fOR HOMESTEAD PURPOSES,
CHI~LOREN IN SCHOOI, PLEASE STATE P<.EASE CHECK: ~ ~
THEIR NAMES: ~
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FILED AND R~COROED~ '
` ST. l'JC~E COUNTY. FLA:°'
. 43.501.4
i
. Vic, ~r'~- ~ 'T9 FEB 23 AN !Q : ZS
_ Ct_ERY,yCiRCUtT CJUR7 - ~
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I FURTHER CERTIFY that I vrc11 register at my local address when the registration books reopen. and oomph wKb all
other requirements of a legal resident a~f this State. -
I FUIi1`HER CERTIFY that I have no intcntioa to return to my former domia'le. and I intend to remain in
JT . LUG 1 E ~ County,
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Florida, permaAend;.
f.
I '
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'~s~ 3•'- . ' may: ~
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s ~ . (Name)
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s (Addraaal .
Sworn to and subscribed before me this day at rf .4~
.
~e ~ , A.D.19_ ~ /
ROGER P01 TRAS, CLERK OF CIRCUIT GOURT
ST. UGIE COUNTY, F~OR10A ~ .
~ _
BY: -
~ EPUTY LERK c~ ,
~ - 0 R PAGE 2468 -
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Aff3 Firm 71 22
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