HomeMy WebLinkAbout1142 Declaration of Domicile and Citiienship
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TO THE CLERIC OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This is my declaration of Domie~7e and Citisenship is the State of Florida that I am filing this dear is accordance. and in
conformity with Section 222.17. Florida Statutes.
I was tormerl a Legal resident of C~ [moo ~ I
ICtty) lStatd
resided at . However. I have changed my domicile to
(Strret aad NumbeN ~ n
and am and have been a bona fide resident of the State of Florida since / ~y ~ i
19 - and I reside at 1 D O !o ~2j .8d ~
(Sire Number)
~.t ~?Qo _ ST. LUG I E County. Florida,
141
and this statement is to be taken as my declaration of citizenship. actual kgal residence and domiede in the State of Florida. {
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Ii FOR THE PURPOSE OF ENROI.LIN6 IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS
TR~O['y AAJa P/gICE
~:=COr~D~ D
4:360'76
'(9 S AM 1 i : 30
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
E other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicile, and I intend to remain in
~ 5 T. L U C I E _ County.
/C~ty) _
~ Florida, permanents; . ,
~ •
~,aw~:::
_ ,
' r'. ~ (Name)
, : r s.; , itti~~ _ (Address)
Sworn to and subscn'bed before me this y day of
a _ A.D.19_ ~ /
ROGER P01 TRAS, CLERK OF G IRGUI T COURT _
s ST. LUG I E GOUNT'Y, FLOR i DA
_ _
BY:
EPUTY LERK .
4304 P,~~14~
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