HomeMy WebLinkAbout2232 Declaration of Domicile and Citizenshi ~ ~
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44303
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This is my declantioa of Domicile and Citisenship in the State of Florida that I stn Sling this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of L2:~e~~..~.,~e and I
_ ~ ICit7) (State)
resided at ~l ~%~P . However. I have changed my domicile to
(Stree! ao Number)
and am and have been a boas Sde resides! of the State of Florida since day of
_ 19~~ and Ireside at / ~ ~ ~,m~~ c?it~-Q
IStrest sad Number)
~ ST . L UC I E County. Fbrida.
(C3ty) - .
and this statement is to be taken as my decLntion of citizenship, actuai legal residence and domiale in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING ~ IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
1919 ~r+Y 14 PK 2~ 15
FILED ANO aECORUtO
ST.LUCIE CO(k1TY.FLA.
ROGER POITRAS
CLERK CIRCUIT COU >
RECORD ~'ERiFiE~.
I FURTHER CERTIFY that I wt71 register st my local address when the registration books reopen. and comply with aU
other requirements of a legal resident of this State.
I FURTHER CERTIFY tha I have no intention to returo to my former domicile. and I intend to remain in
T. U C I E County.
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` Florida. permanenci; .
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PUNT
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°~F CUN~~' (Name)
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(Address) `
Sworo to a~ snbsen"bed before me this ~ day of
-T• ~
A.D.19_ ~1
ROGER I TRAS CLERK OF G I RGUI T COURT
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ST. UGIE COUNTY, FLORt
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BY:
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E P UT Y L E R K 3QCr JlJO JACE22~?., =
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