HomeMy WebLinkAbout1331 C~~~lara$e~~ ®ami~il~ a~~ ~iti~~~n hip ~ ~
43'~9'7t~ •
TO TILE CLl•atK OF' THE CIRCUIT COURT.
ST. LUC 1 E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aaordpnce, and in
cot?tormity with Section 22`L.17. 1•'lorida Statutes. '
I was forme a legal resident of ~ ~ TO IJ _ _ V
1 ~/?~~4 and 1
(City) IStats)
resided al S~ G ~ ~A~ D - However. I have changed n?y dcmici'.e to
(Street aad Number)
and aniand have been a bona Cde resident of tho Stale of Floridi since ~ L!P 5~_ day of
. ~ v~•
I9
'7
9 - and I reside at ~ ~ ~~s.!''~~"
(Streetsad Number!
CS u TDOO~P /PF SD Q'iS o F /4a,~~! C ~ ST . L UC I E - County. Florida,
tCit~?
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OP ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IH SCIi001., PLE/1SE STATE PLEASE CHECK: r-s,/ ~
THEIR NAtaES:
FtLEt; A`ft~ RECflRb1r.D'
I.UC~F ~OUNTY.~Ft.A.
~a;~~~
- '79 MAR 2 I AN 10 ~ 4 I
CLARK CtRClll a CCUR7"
I FURTHER CERTIFY that I will register at my local address when the registration books rcoaen. and comply with al!
j other requirements of a legal resident of this State.
i
~ I FUItTIi1:3 CERTIFY that I have no intention to return to m~fo~rmer domicile, and I intend to remain in
~ ST , U C 1 E _ County.
(Gift! .
e
~ Florida, permancnti; .
t
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~`~1~yyt .
~G,~~_`dT 'ri
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~ 5 ~7
`rte ~..1
f~.i?s:.'~
i, - ~ i~..t~~ .rte ~Jl.. -
~i, ~o iNamo!
`F ~curtr~, ~ IDUORS 11~~.5yfi~.~ Q l'= /q~ ~~CCXJ
s / (Address) ~=~A
4 n l?scril?ed before me this ~ . da • of ' ` ~ ~ ~ i
. w ern t and su,, ~ Q ~ )
rn'e'ti-~`'r` A.D.19_. C~~ sT~~C Lam, 1~c! N~•~i r R c 3l Sf--~~ ~ .
_s 79 ~
i
ROGER POI TF2AS, CLERK of G IRC__UI T COURT ?
ST. LUCIE COUNTY, F~ORIUA ~ ~ M~
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tPUrY LERK ~
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