HomeMy WebLinkAbout0132 Declaration of Domicile ana Cr(f~G~~s<<~~
100 TH>r (~~RK OF THE CIItCUIT COURT. 4a~a5a3
STy LUG 1 E ~ OOUI~ITY. FLORIDA: t
~ This k deeLratioa of Domicr7e and (:Itisenship in the State of Florida that I am flies this dsT in aooordaaoe. and is
ooaloTmitT with Section 2?1.17. Fbrida Statutes.
I was f~ a legal resident of aad I
~ tS~W 't
resided at 3 ~t Aowever. I have changed m~ domic~e to {
_ an_d aa~ aad have been a bona Sde resident ottbe State of Floridasince ~ ds7 d
19.~~.. and beside at - l
aed NomD~
f • _ ST. LUG I E ~;d,,
It~bl
and this sLtement is to be taken as mT declaration of citizenship. actual legal residence and domie9e in the State of Florida.
~IF FOR THE PURPOSE OF ENROLLING ~ IF FOR HOMESTEAD PURPOSES,
CHILDREN 1N SCHOOLr PI EASE STATE PLEASE CHECK:
THEIR NAM S: -
t
. ~9I9 A!!; 22 P~ ~ 28
CtIMEU1T COURT
RECOiU)'VEP.tFIEO__.____________
a
~ I FUR1'1~:R CERTII'Y that I wal register at mT local address when the registration books reopen. and oomplT with all
other requir+ementa d a legal resident of this State. -
I FURTHER CERTIFY that I have no intention to return to mT former domic9e. and I intend to ~ remaia in
i T~ _ U C E Conntj.
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Fbrida. parmanend,;
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Swore to and snbscnbed before me this ~ daj of ` r' ` -ct 33 S.?J
w.n. is
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R A C K OF CIRCUIT GOUtT _ _
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r~ . •
F ~
ST. LUGIE COUNTY, FL 1QA
•
BY: ~
• _ E PUTY t.ERK
' _ ~
I)K c~ 5 PIGS ~ : ~
~O~K J1 - , • ~