HomeMy WebLinkAbout0531 c
Declaration of Domicile and Citizenship y~
44~904
TO THE CLF.RK OF THE CIRCUIT COURT, •
_ ST . L l1C I E COUNrY. FLORIDA: ,
i
This is m~ dedaration of Domic~e and Citiuaship in the Stal.e of Florida that I am Gling this da~ in aceordance. and ia ~
conformity with Section 222.17. Florids Statules. ~
,l
I K as formeriv a legeJ residenf of ~~/Y~
~L L~l~, tW hl~G RS ~ y ~a i ~
~c~t>> ~s~,w
resided at 11~~1Y.~ ,~y~ . However. I have changed m~ domic~e to ~
(Stree~ and Number) f
and am and have been a bona fde resident of the State of F7orida aince L Z y da~ oi : ~
L , 19~_. and I reside at ~ 7 Z ~ 1h~ . /~E ~U k S T ~ R/ 1/ G ~
(Street and N~woDer) ~
~o/~ T~~~ L G/ tr , ST. LIJG I E Count~.FJorida,
I~e~) ,
~
and this siatement is to be taken as my dec]aration of citizenship. actual legal rrsidence and domic7e in the $tate of F7orida.
IF FOR THE PURPOSE OF ENROIIING IF FOR HONESTEAD PURPOSES~
CHIIDREN IN SCHOOI~ PLEASE STATE P~EASE CHECKS
THEIR NAMES:
- 1919 JtlN 22 A!~ il= 27 -
f1~f0 AI+O RlCUHI1~0
s ROGER
POITRASA.
CLERK CIRCUIT C
- RECORO YE31f IED__
_ ~4~904
s
~ - ~
j I FURTHER CERTIFY that I w~11 register at my local addre~s when the registration books reopen, and comply w*ith all ;
¢ other requirements of a legal resident of this State. :
~
I FURTHER CERTIFY that I have no intention to return to mp former domicile, and I intend to remain in
f ~
~ T. U C 1 E .~~t~. ~
: ( K'~
[ -
€ Florida. permanenti;.
r:
~
~ ~
~ GOU~~1 ~r y~/J I,,/ ~
~ " . •'E';:? c'G : ~-Q~~ ' ~ / ~d~'7~!/7 ~ s.
~ ~J~~~j ~ ~,`s ; ~
~ L~' " c cn ~ ~
_ / ' ~ • <
i
~ ' V; ~ ~w~ . .'OQO~ . . ~
~~'t ~ Rri ~~~d
J~~E ~OUM~~' (N ~
~ _ ' `
4 ~
s
y (AddreY) ~
# S•~orn subscnbed betore me tbss ~~da~ of
~ _ -
~ A.D. 39_. - . . -
F R I TRAS CLERK OF G IRGUI T G0t~2T ~
~ ~
~ .
~ ST. LUGIE COUNTY, FLOR1 A • ~
~ '
~ BY: .
~ -
_ ~ ~ .
~ EPUTY LERK , ~11 ~ ~
~ 3~ipr AG: '
~ .