HomeMy WebLinkAbout1894 D claration of Domicile and Citiaenshi
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4:38320 - .
1'0 Tl1E CLE1tK OF THE CIRCUIT COURT, '
ST. LUC I E COU1V1'Y, FLORIDA:
This b my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.1?. Florida Statutes.
I was for•,
merly a legal resident of BORN 1 N STATE O F F L ~t F D A and I
ICity) lStatel
resided at . However. I have changed my domicile to
(Strut and Number) '
and am and have been a bona fide resident of the State of Florida since day of
-19 - and I reside at JCL' 9 C~rESn bE /~I
?C
l3aest aad Numbu)
~~,,,Q-,.- ~,•ERc~ - ST. LUC I E County. Florida, _
tats) .
and this statement is to be taken ss my declaration of citizenship, actual legal residence and domicile is the SUte of Florida.
IF.FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSESr
' CHILDREN IN SCHOOLa PLEASE STATE PLEASE CHECKS
THEIR NAMES2
. rnU'VTY.::I_A.'
- L•r ~,r. F.~
~ r U
438320
~~s r~;~ z ~ ~ i ~ : 3 e
r , ; ~V
CGEf~K CIRCUIT CCL'F'~
THE ADR 1 AN M. SAMPLE SCHOI_ARSHI P TRUST
I FURTHER CERTIFY that I wr71 register at my local address when the registration books reopen. and comply with all
~ other requirements of a legal resident of this State. -
i
r
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
J~. U C I E _ ,County,
E _ ~
IGt~I
Florida, permaneati;.
1
.
- ,
~ - (Name)
r... IAddreyl..
~ ~vrorn to and subscribed before me this ~ ~ day of /~ti~/ZC c ~ ~~A
9 y
~/4QGN , A.D.19_ .
a~
- .
~ ROGER POI TRAS, CLERK OF CIRCUIT COURT
_
. ~
ST LUG 1 E COUNTY F>_OR 1 UA ~ ~ . ~ -
E3Y: -
EPUTY t.ERK
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