HomeMy WebLinkAbout1110 Declaration of ®omicil~ and Citia~nshi
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TO TILE CI.EItK 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 Ciling this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of ~~QC/ ~ _ ~ec~ Y ~Z~ and 1
tCK71 1Stat~)
resided at - ~ , However. I have changed my domicile to
(Stre+t aad NumEsrl y,,
a nd am and have been a bona tide resident of the State of Fbridasince / ( 4r? ~-~+1-~s~i~ ~ 14 y~ day of
q .19~ and 1 reside at ~as~ F t-ci1 ~LC~ G.s.~
(8tree~ and Numbarl
Y~"r~.~" 5-~-~~tc; c, ST. LUG i E
County. Florida,
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and this statement is to be taken as my decoration of citizenship. actual legal residence and domia'le in the State of Florida.
IF fOR THE PURPOSE OF ENROLLING IF i0R HOMESTEAD PURPOSES
' CHIt.DREN IN SCHOOLr PLEASE STATE PLEASE CHECKt
THEIR NAMESS
FILED t.NQ RECORDEB'•
• LJCIE •":QUNTY. FLA.
439'766
'79 APR 4 AN 10 ~ 43
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CLERK CIRCUIT COURT.
I FURTHER CERTIFY that I wt11 register at my local address when the registration books reopen, and comply with all
ocher requirements of a legal resident of this State.
• I FURTHER CERTIFY that I have no intention to return tom former domicile, and I intend to remain in
f y
. U C 1 E County.
ICK~I
I Florida, permanenti;.
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~K~orn to and subscribed beforo me this day of _ '3-~dl ~ ~Q Q{ 3.3 S/S~( _
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A.D.19_
ROGER P AS CLERK OF CIRCUIT COURT
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ST. LUCI E COUNTY, f LOR t A
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EPUTY LERK
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