HomeMy WebLinkAbout1185 - ~ • • ,
•t a
Declaration of ®omicite and Citizenshi
• ~ 439"'!94
TO TIIE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aernrdance. and in
conformity with Section 222.17, Fbrida Statutes. e r /
I was tormcri,~ a legal resident of s • L ~ U ~ e ~ a Q' ~ ` `Q and I
. ICit~) (State!
resided •t . However. I have ehaaged my domicile to
lStrset and Numtiet)
a nd am sad have been n bona Cde resident of the State of Floridasince ~ ~ day of
Se rn~be r 'S8 6~ 7 i'7
P , ><>a_.,_. and I reside at o r 1 2a Ir1 L d ine
• (steeet sad Numbr)
~e r ~ `j~' •1~~.-. V CIS ~ . ST. LUG 1 E County. Florida.
and this statement is to be taken as my declaration of citizenship, actual legal residence and dotnicde is the State of Florida.
IF.F'OR THE PURPOSE OF ENROLLING IF fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOIr PLEASE STATE PLEASE CHECKS
THEIR NAMESS
FILED •AtJD REC4RD~Dt
ST. LUCIE COUNTY. FLAT
.=~CQnO `1~HIfIFD
439'794
'T9 APR y P14 12:35 ~
-
ROGI•~ i'Q~1i~a~
CLt:RK CIRCUIT COURT
I FURTHER CERTIFY that I w~71 register at my local address when the registration books reopen. and comply with all
' other requirements of a legal resident of this Stara.
1 FURTHER CERTIFY that I have no intention to return to mr former domicile. and I intend to remain in
_ - - - 5~ ~ ~ ,County.
i t(StT)
Florida, permaneoti;.
4
pF
C
~ vt o
-
_ (Name)
-
(Addeew)
ff Sworn to and subscribed before me thin / day of
, A.D.19_ ~1
ROGER P01 TRAS, CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, FLORiUA
• .
BY:
EPUTY LERK
+ 1!