HomeMy WebLinkAbout2250 Declaration of domicile and Citia~nship ~
43.8536 .
Tl~ T11E CLERK OF THE CIRCUIT COURT.
_ ST. LUC I E COUNTY. FLORIDA:
This b my declaration of Domicile and Citisenship in the State of Florida that I am filing this day in aecordanrn. and in
conformity with Section 222.17, Florida Statutes.
I was tormerl a legal resident of Po ~ r S ~ L ~ t F /C~ n 1P / ~ A7/'~ and I
{City) lSta.e)
resided at ~ ~ o Nf L~Ilo-o ,0. pit? . However. I have changed my domicile to
(Strut and Numbsrl ~L
and am and have been a bona lido resident o[ the State of Florida since L~-(2.? O ~ ~ day of
_ .19
7~
- and I reside at S y ~ G N T h~1r n ~ D • ,~iP,
(Street aad Number)
d R •r t L y CL i~ ~ . ST . L UG I E County, Florida,
tCtt7)
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 OF ENROLLING IF FOR HOMESTEAD PURPOSES,
' CHIIOREN IN SCHOOL., PLEASE STATE PLEASE CHECKS
THEIR NAMESS
d ~ N ~T_~ ~ ~ ~ U ~T FILED t.PiD RECORDED=.
~~W~
+79 NCR 26 PM 12:01
t. _ ..Dt7~. _
CLE~tK CiRCl:l7 COiJRT
I FURTHER CERT1Flf that I will register at my local address when the registration books reopen. and comply with all
other requirements of a legal resident of this State.
k
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
T. U C I E ,County,
j (City)
E
Florida, permanenti;.
t -
c'~"~
^_~{7
;y_.f`-j~ {Name)
- ~
v~~~~` o~ S ct 11J L'' 1V T /.t,, o o D ~ /~/f' ,
(Addreu)
z ~
i sworn to and subscribed before me this day of T _S T jit {G, C_ ALT ~ G ~
~~C1~?c , A.D.19_
ROGER POITRAS. CLERK OF CIRCUIT COURT
S T. L I E COUNTY, F LOR t.U ,
E3Y:
EPUTY LERK
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