HomeMy WebLinkAbout0421 Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT COURT. ~
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ST. LUC 1 E covr~r, ~-[,oRro~:
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This is my decluation ot Domicik and Citizenship ia the State of Florida that I am filing this day ia accord~aee. snd in ;
rnnformity with Section 222.17. F9orida Statutes. .
I wss formerl a legal resident oi 6'E ,`f l i°a I
lClt7) ~State)
resided at p7 7 F wA~T /T v E . However. I have cbanged my domic~7e t.o
(3tre.t and NumD~) 7?y~
and un and have beea a bona Cde resident of the Stste ot Florida ainoe 3~ day ot ;
~/L~C. ~ 19'g - and I reside at ~O ~ 'Q ~•~vC~ ~~d•v f ;
/ ~ (SteMt and Numb~r) ;
`%`Al_S~E'.~/ ~i~A~P/O/f~ . ST . L UC I E Couat~. Florida. i
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and this statement is to be taken as my declarAtioa of citiunship. actual legal residence aad domie~e in the State ot Florida. ~
If F'OR THE PURPOSE OF ENROLLIN6 IF ~OR HONESTEAD PURPOSESi
CHIIOREN IN SCHOOI~ PLEASE STATE PIEASE CHECK: r~ ~
THEIR NAMES:
ED A`~J r~ECOR0~01
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'79 FER 28 AM I i: 59 ^
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I FURTHER CERTIFY thst I w~71 register at my local address when the registration booka reopen, snd comply with aU '
other requiremenis ot s legal resident of this State.
` I FURTHE,~ CERTIFY that I have no intxntion to return to my former domic~e. and I intend to remain in
~ ~ T. U t! E _ County.
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~ Florida, permanenti;. ~
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~ Sworn to and subscn'bed before me this ~v dsy of
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9
' ROGER P01 TRAS. CLERK OF C IRCUI T COI~ZT
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ST. IE COUNTY, FLORtDA . .
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~ BY:
~ ePUTY IERK t~
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4(;n F';,r.~ 71
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