HomeMy WebLinkAbout1375 Declaration of Dor~nicile and Citizen hip ~ ~
443756 ,
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E C,OUI+l1'Y. FLORIDA: .
This is my declaration of DomieDe and Citizenship in the State of Florida that I am filing this day in aooordance, and in
confornuty with Section 222.17. Florida Statutes.
I wis form___
erly a legal resident of l- Q4 L~ °!~Q QS X11 ~n A sad I
ICit71 IStat~l
resided at _ I~ O O m ar ~ 1 h ~ t 1 e _ . However. I have changed my domicile to
13treat and NumDar)
and am and have been a bona fide resident of the State of Florida since ~ -day of
m aV ,19..!
~ and I reside at 9 Pc~r IC wood [ a,~nr.~~.
IStr..t and Nambar)
P-~. L. u a f; ~ ST . L UG I E ~ County, Florida.
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and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the $Lte of Florida.
IF FOR THE. PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: _
tie_LIt ~ ~rr~w orH
•919 SAY -g ~
FILED RMC NFCOkUEO
ST.LUCIE C TY.FtA.
RO&ER P~TRAS
it£1111 CIRCUIT CO
RF~Ra YERIFtEO -
443'756
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I FURTHER CERTIFY that I will register at my local address when the registration hooka reopen. and comply with all
other requirements of a legal resident of this State. '
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
T. U C I E _ County.
1(~trl
~ Florida. permanenti; . •
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UGC ~.:?J w ::F~S`~ P~~'
~r CaUt~iY, f`O (Name)
20 ~t g pew-.~.~d• Gam,
2 ~ (Addrera •
Sworn to and snbacriibed before me this ~ day of _ EJ
~ ~ - .7,.,i_
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//L~.c~ A.D.19
, ~9
ROGER P01 TRAS, CLERK OF G I RGUI T COURT
ST. LUG I E COUNTY, ftOR 1 DA - •
,
BY: .2~9~C.~ - ~
_ EPUTY LERK d~~V - .
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