HomeMy WebLinkAbout2118 _ - - ~Vn. _
Declaration o~ Domicile a~nc! Citizenahi ~ }
- p ~ -
r
700 THE CLERK OF THE CD;CUIT COURT. ~~S~O
STS L (1G 1 E COU~y FLORIDA:
g'his is ~ declaration of Domleile and t2tiseashlp in the State od 1:7erida that I am Slim this dq is sooordanee, and b
cbatormit~ wfth Section 222.17. t7orida Statutes.
r ~ _
I was f
~ a ~ resident as and I
tCty) 18
resided at Howevsr. I haw aaged mT domie9e to
16v..tasd .
and sat and hyav~e
been a bona Sde resident of the State od Florida sins . ds,T e[
~ ,19~~.. and I reside at ~ 7 O y
~ f~ t8v.et aai I~Imb~rl •
w ~ ~f's i
~ -w ~ ST • 1/ ! ~ C011nt~~ " Orida.
,
and this stateme~ is to be taken as m~ declaration os citizenship, adual legal residence and domin'le in the State of Florida.
If FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSES, ~
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
.THEIR NAMESS
f.
- ~~i~A
t i
l{F
a l9T9 AUG 16 P!I I: 18
F LEO Abp RECO Ep
Si~ LUCiE COUNTY.FLA
Clt
~ CSC
OlTC~4T '
RECORD t'ER?FIFD ~ - ~
Y
I FURTHER CERTIFY that I will register at mT local address when the registration books reopen, and oomglT with all
other regoiremente of a legal resident of this State.
I FIJRTHER CER77FY that I haw ao intention to return to former domin7e. and I intend to remain in
,yt„~b i.~• U C 1 E . CouM,~. .
_ ICtar)
l Fbrida, permanentt~•. •
k
C
_ ~ou~ry
LsO
4 V s ~
~ ~
6 ~ .N
~
I ~
~ 7 D ~ ~~c~L~-~/~~ ~in~.~
) uwa~.•a /
sworn to and snbsabed before me this _.,L~ dq et _ ~ _ •~~.t , _
~ _
~ A.D.19
~ ~1 - -
i
R A CLERK OF GlRCUIT GOURT .
1~ • ~ ~ I
ST. LUGlE COUNTY, FLORt - _
~ .
BY:
• EP t.ER.K ~O~K3~4 PAGE~~1~ ;