HomeMy WebLinkAbout0567 _
Declaration of Domicile and Citizenship ~
• .
- ~ 459
-
'ii0TAE CLERK OF TAE CIRCUIT COURT. '
r
_ S~~ LUG 1 E apuNTr. FLORIDA:
~`,Y'his b ngT deeleratba ei Demieils and Citiseaship in the 8tste a[ 1:7o:ida that I am fittnt thie dy io aooo:dana. and is
- _ eoaformil,T will, Section 22t.1T. Flodda Statutes.
~ . _ ~I , ~ _ and I
I was I~ a legal resident o[ -
~ • 1031 tetwl
resided st 1,~ ~o `/1 ~L3 , a[g„~~ - Aowever. I hive Changed ID' dOmiC~le t0
--T~ l&rMt aed Nasb~ ~
and am and haw been a bona fide resident eithe State otFlorida since ~ dal d
lll~.~.. and I r+0eide at ~~~T~-~==~ er~t ue N.eb~rl ~ -
ST. LUG I E •
and this statemed is to be taken as m,T declaration OI dtisenship. adusl legal residence and domieDe, is the State d Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR IIOMESTEAO PURPOSES, .
CHILDREN IN SCHOOL, PLEASE STATE _:~LEASE CHECKS ~ s
TNE1R NAMESS / {
~O i,cJ' ~ ~ . ~LLi- ~l
X19 A1~ -8 PM 3 19
attdt cult
- I~ECam v~F~o~.
454239
I F[TRTAER (~RTii''Y that I w~71 register at mT local address when the registration books reopen. and oomph with aD
other regniremeMs d a 1ega1 resided ai this State.
li I l:'tJR'PI.1ER CERZ'II~'Y that I have ao intention to return to former domiede. and I intend to remain in
T ~ U C I E Co~mtT.
i(xt~) '
i''brida. permaneatl;
.
- oUNry
,~b,,~•~:`":~CO
~ G
- v ~ ,A -
vt ~ -:~n ? ~
ccuxj~ ~ ~a ~ ~ Q -
IAddew) 3
Savors to and sobseribed before me this ~ da7 0[
.
A.D.19
~
$OGER POI TRAS. CLERK OF G IRGUI T COURT
~
ST. LUGIE COUNTY, fLOR10A .
_ .
BY S -
}
• EPUTY LERK
_ - ,