HomeMy WebLinkAbout2878 r tion of Domicile and Citizenship ~f
Decla a
43034
TO THE CLERK OF THE CIRCUIT COURT,
ST. LUG I E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship is the State of Florida that I am tiling this day in aaordance. and in
conformity with Section 222.17. Florida Statutes.
I was former] c legal resident o ~ I
_ ICft71 ~ IStala)
resided :t . However. I have ebanged my domicile to
(Street and Number) t
and am and have been a bona fide resident of the State of Florida since ~ day of
/`I _19Z1~
and I reside st ~~`s~ ~ "'~~~''J
(3treat sad Number)
_ S T. L UG I E County. Fbrida,
Icscyl ~ ~
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
r
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, f
CHILDREN IN SCHOOL, PLEASE STATE - PLEASE CHECK:
THEIR NAMES:
. ~
.43`7034
_ -
I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with aU
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
. 5 T. L U C I E .County.
ICit71 - ,
Florida, permanenLl;.
~ ~
1
g, COON
4V
!G
;4
ce .yam
C:c' A: rltiS.: O'
~ ~~O S (Name) _
C~uNTY, F~~P`
f ~iI
~~,pp 1
Sworn to and subscn'bed before me this day of 7``~ • ~ ~3 ~SZ
ROGER P01 TRAS, CLERK OF C I RGU I_T_COURT
s
ST. LUGIE COUNTY, FLORIDA
BY:
EPUTY t.ERK
T ~ 1
` l•,1
3C~r
- ~cn e, ; t 22
. - -
_
r
t~ -