HomeMy WebLinkAbout0122 ~ . . . . . _
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Dectar~tion of Domicile and Ci~i~~ns~~~ ~
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TO THE CLENK OF THE CIRCUIT COURT. ~
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ST. Ll1C 1 E (;pUNTY~ FLORIDA:
This b my decluation ot Domieile and Citisenahip ia the State ot Florida tha! 1~m t'iltng thi~ da,y ip ~ocordaace. and in
conformitr wilh Scclion 222.17. Rlorida Statuies. !
' N/A ~MY DA0 MAS M?LtTARY~ ~I ~
1 was formcrl • legal nsident ot
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resided at N~a - HoMever.I bave cbaaged u~r domicile ta
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and am and haye beea a boaa Cde naident of the State ot Florida sinos day of ~
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64 . and I reside at ~ R T• 1 BO X 752 ~ `
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F 0 R T P 1 E tt t~ _ ST . l UC I E ~ountr, Florida,
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and this slatement ia to be taken as my declaration ot titi=eaship. adual legal nsideace and domic~e in tbe State ot Florida. ~
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If.iOR THE PURPOSE O~ ENROLIING IP fOR HOMESTEAC PURPOSES~
• GHlL~RE!! !N SCHOOL~ P~EASE STATE . PLEASE CHECK:
T H E 1 R N A M E S.
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' FttE~ A~~~ RECORQEO' _
f~sf•~~ rnV?~:TY. FL'A:. _ ~
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CLERK CIRCUIT COURT
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i I FUFTHER CERTJF'Y that 1 w~i ngister at my local address ~rhen the registntion books reopeo. and compt~r witb all F
~ o;her rE,yairemenb ot a kgal resident of this State. ~
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1 FURTHEc'~ CERTIFY tbat I have no intrntion to return to my lormer domicile. and I intend to remain in
J T. L U C 1 E ~ County. ~
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~ Florida, permaneati,;. 3
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~ Gp~NTy~a ~ n ~ ~
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v= CHARLES ~'~i~ GATE HE~IITT~ I I
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~~S orn to and subsen'bed bs(ore inc this ~ dsy of 3
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~ ROGER P01 TRAS. CLERK OF C IRCUI T GOU2T i~
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' S T. L UG I E COUNTY, F LOR 1 •
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• EPUTY LERK ~
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~ . ? f. . r • Af~n Form 71 'L..'~
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