HomeMy WebLinkAbout2673 D claration of Domicilo and Citiz~nshi
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• 9140'766 .
TO THE CLERK OFTHE CIRCUIT COURT. '
ST. LUC 1 E COUNTY. FIARIDA:
This b my declaration of Domicile and Citisnnship is the State of Florida that I am ft~ing this day io accordance, and in
conformity with Section 222.17, Florida Statutes.
•
I was tor~mcr_•1~ a k~al_
~ ent~t y.: and I -
4, ) (state)
resided at However, I have changed my domicile to -
1 Numeerl
and am wad have been a bona fide resident o State of Fbrida since ~ ~ day of
r e ~~.c..~ ,19~ and I reside at 3 ~ ~ ~ ,
• ~ (Street Nambr)
ST. LUGIE
IAR1) ' • Couoty. Fbrida.
and this statement is to be taken as my declaration of citizenship. actual legal residence wad domiei7e in the SUte of Florida.
IF FOR THE PURPOSE OP ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOIa PLEASE STATE PLEASE CHECK:
THEIR NAMES:
FILED ~PJD RECORDEt)-
• ~T. L:fC;c: COUPJTY, FLA.
~.sv 166 _
'19 APR 16 AM 10:3 Z
CLERK CikCJtT ~OilR i
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, wad comply with aU
other requirements of a legal resident of this State.
i
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
_ 5 i~ ca
c
t
i _ County
1(xtrl
f'i~rida, permanenti;.
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~ S ~•orn to and sut?scn'bed before me this _.,L~ day of ~~'Q-T Ir I ~7~t~ /CL.. 3 3 y SD
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~ A.D.19_ ~1
• -
F J
r ROGER P01 TRAS, CLERK OF CIRCUIT COURT t~'
~ :~i
,
S T , L UG I E COUNTY, f LOR t UA _ ~ " s~?
d ~ EPUTY LERK
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