HomeMy WebLinkAbout2808 Declaration of Domicile and Citizenshi ~ ~
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TO THE CLERK OF THE CIRCUIT COURT,
ST. LUC 1 E COUNTY. FLORIDA:
.
This L my declaration oI Doaaicik and CItizenship in the State of Florida that I am ~i thG day in sceordsnce. and to
rnnformity with Section 222.17. Florida Statutes. ~ ~ _
I was former a legal resident of TQ ~t ~ ~t 5 S { 'e- , , ~~D r" ~ O0.. and I ;
Q _ 1CK71 l8tatd
resided at ~ S/ ~ 9 a ~ /C a K ~ 1' c~ . . However. I have ebanged air domiei'1e to
(8tre.t and NasbK) ~ .
and am and have been a bona fide resident of the State aIFlorida ainee - acy ~ day of I
1>i~~. and I reside at ~ • Sofi~c.~ ~ ~ rc /e. ~
(8tr«t and NumbKl
~Q R T S ~ - ~ u P i ~ ST . LUG 1 E County, Florida,
. coral ~ - ~
and this statement is to be taken as ~ declaration o[ citizenship. actual legal residence and domic~7e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING Ii POR HOMESTEAD PURPOSES,
CHIIOREN IN SCHOOt.,.PtEASE STATE PLEASE CHECK:
THEIR NAMESS
_~on n. u ~ a rdoyr LU~i %~e tp q~lp RECOROt:~~ .
- ` t, ~,F CpUR;TY FLA.
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'79 f E6 26 ANI 1 i : 49
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I FURTHER CERTIFY that I w~71 register at my local address when the registration books reopen, and comply with -all ~
other requirements o[ a legal resident of this State.
I FURTHER CERTII~'Y that I have no intention to return tom former domicile. and I intend to remain in i
T. U C 1 E_ ,County. ;
tCit~l _ ~ t
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Florida. permanentl;.
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Sworn to and subsen'bed beforo me this ~ to day of i
s
Qi~, . A.D.19_
ROGER P01 TRAS. CLERK OF CIRCUIT COURT
~ ST. L UG I E COUNTY, F t_OR t OA ~ ~ .
BYt _
F
! EPUTY LERK
• ACO Form 71 72
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