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HomeMy WebLinkAbout0711 4 ' Declaration of Dom~icile and Citizenship ~ . ~ 1 449025 ~ TO THE CLERK OF THE CIRCUIT OOURT. ST. lUC I E apU~y. ~,p~A: . ~ ZWs is m~r declaration ~ DomlrDe aad Citisenship in tbe 8tate ot Florida that I am SHns tl~ dap in aooordanas. and ia ; oonformit~ witA Saetion 222.17. F7orida Ststutes. ' I was former a bgal reaident at ~ Q 0 t~aw As~o~ , 1~ e vv V ec k ~ i . lt~t71 18tat~) reaided at 13.5'N nrn b o~da p. . Ho~rsver. I luve ebanaed ~ domie~7s to ; ' 1 a~d NooDr) sod am and bave been a bona 6de resident ot t6e 8tate at Florida sinoe ~ f* dq ot Su n< ,19 7 Q_ aad I reside d ~`~~o~i l.~ ~a v~an 2 c~ , ' l8te..t a.d Nosb.r) ~ e r E S~ t, u c~ e ~T . i. w i~ Count~. F'loeida. IG41 ~ and this statement is to be takea as an~ deelaration of dtiunship. actual legal residence and domieile in the State oi Flosida. IF fOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES~ CHiLDREN.IN SCHOOL~ PLEASE STATE P~EASE CHECKt THEIR NAMES: j 1 ,~i9 ~ =i ~i 2 S ~i? • ~ ~ • ST~Lt~C1~C0i~ili~ A. . ROC~E ~aiT C!~'RK CIRCUIT ~ ~ ~ . .~~~Fr__Qr T I~ ~ I FUATHER CERTIFY t,Lat I w~l register at m~ loeil adde~ess w6en the registration books r~open, aad oompl~ wit6 all ; other nquiremeMs of a kgal reaident of this State. i ~ I FUBT'~iER CEATIFY t6:t I have no intention to raturn to m former domic~'k. and I intend to nmain in ~ . U C 1 E . County. F . - ' i Florida: permanentl; . ~ ~ ~ ~ ~ ; ~ ' _ 1 ; ~ g, COUN ~ ClF'Rq'"~. ~ _ ~v~ ~ ~ - ~ ~ V: ~ ~ i F N„~=.~s ~ , f?C) • 4f TR.Ji ~ : ' q ~ . n . ~ ~ . . . _ 2 •~,/l~ b ~~Q~c~) ~ d .~4, (Add~ws) ` ~ Sworn ta and snbsrn'bed belore me this da~ at ~or ~ S~. L c, c; ~ ~14. 33 ~i~(S'2 . ~ _ T~n t ~ A.D.19 : . > 9 s ° ROGER POITRAS, S ~ CLERK OF C IRCUI T COUtT ~ . - ~ ST. LUGIE COUNTY, FLORtOA ~ - ; ~ • ~ L ~ BY: - ~ , ~ E _ EPUTY LERK U~ . ' ~ _ , ~ooK 311 ~~E 710 . ~ ~ _ . r~ +