HomeMy WebLinkAbout2802 Declaration of Domicile and Citizenship .
.4,5241
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This b my declaration of DomkIle and Citisenship in the State os Florida that I am »g th4 dsy in aacordanoe. snd is
conformity «ith Ssetion 222.17. Florida Statutes.
I was former a legal resident of T
NA ~.ow.0 s ..rlY~ and I I
ICWI l&atd
resided at I rI S~ ~1/~~iJ~-hoR~/er ~n~a - However. I have changed m, domicile to f
i8trMt aa~ NumD~
and am andhave been a bona fide resident of the Sbte of Fbrida since ~7 ~ i
I
~ 19?
S! and i reside at .~1~ ~)~?1 s r 7~R~n~~ l.~is rb lj~uD
(SteMt aad Ifi~ebar) - 't
ST . LUG 1 E County. Florida.
Its) - ~
and this statement is to be ta>ten as my declaration of dtittnship, actual legal residence and domicile in the State of Florida.
' If FOR THE PURPOSE Of ENROLf.ING IF FOR HOMESTEAD PURPOSES, .
CHILDREN IN SCHOOL, PLEASE STATE .PLEASE CHECKS
THEIR NAMESS ~ r 1
o
ED RECORDED -
~~~~c : CU'~JTY. FL.'.,.
43.5241
'79 FEB 26 ~M I i : 39 !
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'i I FURTHER CERTIFY that I ~ register at my local address «hen the registration books reopen, and comply «ith all E
other requirements of a legal resident of this State. .
I FURTHER CERTIFY that I have no intention to return to my former domiu'le, and I intend to remain in
- T. U C 1 E 'County.
Florida. permanen~,~.
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q 1
' 1
i
. ~
. ~ (Name)
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S«orri to aed aaD~kribed before me this _~C~e~ day at f
f
j.:
~e ~ . A.D.19_ 79
ROGER F'01 TRAS, CLERK OF G IRGUI T COURT
ST. LUGIE COUNTY, FLORIDA ~ .
BYs
EPUTY tERK -
a ~ R~ c W
. X001! ~ YAC~G~ .
Afn dorm 71.E
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