HomeMy WebLinkAbout0479 r ? ~ c . .
tion of Damicile and Cit~a~nshi ~
Deciara ~
44~288 ~
TO TtIE CLEItK OF THE CIRCUIT COURT. ~ ~
ST. LUC 1 E CpUt~1~~ FLORIDA:
This b my declantion of Domicile and Citizen~hip in the State ot Florida that 1 am t~ng this di?p ia ~?ccordanc~. and in
contormity w?itA Scction 222.17. Florida Statules.
I wu tormerl a Iegal re~ident ot ~ ~"d I
. 1 # lCit71 tSut~)
resided at ` ~ . However. I have ehanged my domicile to
~sc~.~.,,ra N,une.r~ /D ~ .
and am and have bcen a bona Cde residcnt of the State of Florida since day oi
,~I ~~r~ I , i~~..~a i~;a~.~ 3, l~'o. 4r~,~ ~ r
n~ (s~re.e aaa Nu~b.~)
F~' f/ C~C ~ _ ST . L UG I E Countr. Florida,
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and this sUtement is to be taken u my declaration ot citizeaahip. aclual legal residenee and doraicile in the SULe oi Florida.
IF.FOR THE PURPOSE OF ENROILING If POR HOMESTEAC PURPOSES~
' CHILOREN IN SCHOOL~ PL-EASE STATE PLEASE CHECK: ~
THEIR NAMES:
_n ~.sii i?:..COR~ FD
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~ ~
44~.28~
+Z9 r~~~ 18 Pi~1 5~
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` ~ i r; . ~ . . ~ , ' .
, I FURTNER CERTIFY that I wili ngister at my local address when t~e registration books reopen. and comply with all
~ o! her requirements ot a legal nsident of this Sbte.
i ~
l : I FURTHER CERTIF'Y that I have no intention to return to m tormer dom~_eil~. and I intend to remsin in
~ - - 1 . v ~ ~ ~ , County.
" 1(Syl . _
~ Florida, permaneati;. ?
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s~. ~ ~ G.. i l e~ a ~ R,
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(Addrea)
~ S w orn to and subscribed before me this day of
~ ,
_ A.D.19_ ~9
~ ROGER P I AS CLERK OF C IRCUI T GOl~2T
ST. LUGIE COUNTY, FLORIUA -
BY:
~ ~ PUTY LERK ~~.~7 ~ 4~
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