HomeMy WebLinkAbout2359 Declaration of D®micile and Citizen~hi ~
TO T11E CLERK OF THE CIRCUIT COURT.
ST. LUC 1 E COUNTY, FLORIDA:
This b my declaration of Domicile and Citizenship in the State of Florida that I am thins thin day in accordance. and in
conformity with Section 222.17. Florida Statutes.
1 was tors~rl
rr a legal resident oI - ~?'Y~- Tn~ ~ nn/l - and I
ICIt7) 18tatel
resided it ~ R~JPf Del ~2 - However. I have changed my domicile eo
(Steeat and Numb~tl .
a red am and have been a boas Cde resident of the State of Fbrida since __.,L~i day of
. i~
~n
_ and I reside at .1~1~ ~rmo~7YI. nJ~rv ie
. (8tnat and Number)
QiP rye _ ST . L UG i E County. Florida,
Iptyl
and this statement is to be taken as my declaration of citizenship, actual legal resideoee and domicile in the State of Florida.
IF POR THE PURPOSE OP ENROLLING IF iOR HOMESTEAD PURPOSES,
' CHILDREN IN SCHOOL., PLEASE STATE PLEASE CHECK:
THEIR NAMES:
•
FLED ;,l:D RECORDE,a~
_;1C~~ ~^URI'~'Y. FLA.
' X79 AI?R 12 AM 10 : i 3
. ~ ~
~LERK i~~ii!_' ~ ,nl
I FURTHER CERTIFY that I wdl register at my }Deal addreu when the registration hooka reopen, aad comply with all
atncr requirements o[ a legal resident of this State.
. I FURTHER CERTIFY that I have no intention to return tom [ormer domie'k. and I intend to remain in
U C 1 E ,County,
Itst~)
Florida, permanemi;.
t
P
c
t
i
~ v
OOUNTy '
J ~~~~w~ •~CGG
v ~ _
ac
to
{ ~
' ~~f COUMn'~ (Name) -
.
r
S ~sorn to and aubscnbed before me this ~ day of I d 1 ~ I Jrmn nlL.. ~~(P11~ le
.
A.D.19_ '
ROGER I AS G ERK OF CIRCUIT COURT
ST. LUCIE COUNTY, FLORIDA
~ BY.
f ~ EPUTY JERK
i
i ry~
U R~ ~ ~IIC~ (rJS~
ACC) F'i..rrn 1)
h
,r -
-