HomeMy WebLinkAbout2509 Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUG I E aovrrr7r, FLORmA:
Thb b ogle declaration of Domidle aad Citisenship in the State of Florida that I am 14ting thb dty is aooordancs. and is
conformity with Section x.17, l'7orWs Statutes. `
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I was i rmer a kEs1 resident at ~x
~ ~ . H ever. I bavs changed rep domklls b
(8terrt Dad NadbM ~
and am have been a bona fide resident of the State of 1!7orWa sins ~ ~ ~ ~ .
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1! -and beside at -
i8trrrt sad Nomba)
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and thb statement b to be taken as ~ decLratioa of dtiunship. actual Legal residence and domieDe in the State of 1:7orida.
IF FOR THE. PURPOSE Of ENROLLING. IF FOR HOMESTEAD PURPOSES,
CN I IOREN I N SCHOOL., PLEASE STATE y PLEASE • CHECKS
THEIR HANES:
• FiLEO~ AND RECORDED:
/ ~j ST. LJC~£ CQUNYY, FLA.'
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- '79 fE8 23 PM X2:08
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Ct_ERK CIRCtiIT COURT
I FURTHER CERTIFY that I w~7] register at my ]Deal address when the registration books reopen, and eompb with all !
other requirements of a legal resident of this State. - -
I FURTHER CF,RTIFY that I have no intention to return to my former domicile. and I intend to remain in -
. - - - ~ T . LUG 1 E ~ COUnty.
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j Fbrida. permanend~ . t
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cif CCUMtY
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Sworn to aad subscn'bed before me thb day d
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ROGER P01 TRAS, CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, fLOR1UA - - .
EPUTY LERK -
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• .4G0 Form 71.22 -
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