HomeMy WebLinkAbout0006 tion of Domicile and Citizenshi ,
Declara p
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TO THE CLERK UF THE CIRCUIT COURT.
ST. Ll1C I E ~ COUNTY. FLORIDA:
This is my declaration oi Domicile and Citizenship in the Stute of Florida that I am filing lhis day ia accordance. and ie
coniormity with Section 222.17. Florida Statutes.
1 was formerl a legal resident oi `1' f~ and 1
/o lCn~l ~ IState)
resided at ~ ~3~~i 0 Nowever. I have changed my domicile to ~
(Strcet aad NumDet) ~
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and sm and have been a bona fiide resident of the State oi Florida ~ince day oi
____~~C~ .19SQ.~. and I reside at q~~
et ~ad Number)
t 1~ ST . L l1C I E Count~. Floriaa,
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and this statement is to be takea as my declaration of citizen~hip, actual legal residence and domicile in the State of Florida. :
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IF FOR THE PURPOSE OP ENROIIING IF FOR HOMESTEAD PURPOSES~,
GHILDREN IN SCHOOL~ PIEASE STATE PLEASE CHECK: ~ .
THEIR NANESI
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` I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
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~ other requirements of a legal resident of this State.
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r 1 FURTHE~Z CERTIFY thst I have no intention to return to my former domicile. and I intend to remain in
t , T U C I E County.
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~ Florida, permanenti; .
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x~ ROGER P01 TRAS. CLERK OF C IRCUI T_ COI~tT ~
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k~ ST. LUG I E COUNTY, FL.OR 1DA :
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~ BY:
~ EPUTY LERK_ .
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