HomeMy WebLinkAbout1385 Declaration of Domicile and Citizenshi ~
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44'7511
TO THE CLERK OF THE CIRCUIT COURT,
ST. LUG I E COUNTY, FLORIDA: {
_ _
Phis is my declaration of Domiet~e and Citizenship in the States of Florida that I am filing this day in accordance, and in 3
conformity with Section 222.17. Florida Statutes.
I w as formerly a legal resident of ~ i'19 wj. S s and I ~
• 1(~ty) (State)
resided at ~ /1 s` D S%
~~`e _ However. I have changed my domicDe to
IStieet and Number)
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and am and have been a bona fide resident of the State of Florida since L ~ day of .
~ U /~G ,19~~ and I aside ai ~ / ~Q ~ [j Y' 1~~
(Street and Number)
~~T S•
~ Z~~n ~ ,p ~ ST . L UG I E County, .Florida,
tcjtyi
and this statement is to be taken as my declaration of cstizenship. actual legal residence and domicile in the State of Florida.
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IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NANES2
9~ ~llH i 2 PN 2~ ~ 0
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~!OITRAS
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44`7511
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I FURTHER CERTIFY that I wt71 register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State. ~ ~
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I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
F
i T. U C! E , County,
tGtit~)
E -
j Florida. permaneati;.
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• C. G
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f Sworn s ~v fore me this day of .S % ,~(1S ~ ;
A.D.19~// ~ ~ .
ROGER POI TRAS, CLERK OF G I RGUI T GOlJ~2T
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s
~ ST. LUGIE COUNTY, FLOR OA
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BY: - 1,
EPUTY LERK '
e g,~~ 310 ~A~~ 135 ' • _ =
.