HomeMy WebLinkAbout2039 Declaration of Domicile and Citizenship H
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TO THE CLERK OF THE CIRCUIT COURT, i
ST . LUG 1 E COUNTY, FLORIDA: .
This is my declaration of Domic~7e and Citizenship in the State of Florida that I am filing this day In accordance, and in
conformity with Section 222.17. Florida Statutes.
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I w ns formed a legal resident of ` and I
y) IS9•ate)
resided at ~ 3 ~ ~ ~QdY(.,+- ~~~-~-r _ . However. I have Chang my domiu7e to ~
IStreet and Number)
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and am and have been a bona fide resident of the State of Florida since day of
19 %
~ - and I reside at ~
(Street and Number) .
ST. LUG 1 E County, Florida,
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and this statement is to be taken as my dedaration of citizenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAp PURAOSESa ~
CHILDREN IN SCHOOIa PLEASE STATE PLEASE CHECK:
THEIR NAMES:
l979 JUN 14 PH ~ 50
FILED ANO FECUROED
ST. `UCIE COUNTY. flA. ~
ROGER POITRAS
CLERK CIRCUt T
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I FURTHER CERTIFY that I wi71 register at my local address when the registration books reopen, and comply witb a1!
other requirements of a legal resident of this State.
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I FURTHER R at I ve nQ intention to return to my former domic~e, and I intend to remain in
~ T. U C I E .County.
lCSty ri
Florida. permanenci;.
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Sworn to and subsrn"bed before me this ~ ~ day of J~.~ys
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V N~ . A.D.19
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ROGER PO I TRAS, CLERK OF CIRCUIT COURT GOU~~T`~•
ST. LUG 1 E COUNTY, f LOR 1 DA ~Jf
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iF COuhjY. i
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a ~ ~_.~.310 N• . .
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