HomeMy WebLinkAbout1816 . ~ ~
Declaration of Domicile and Citizenship
462'7`78
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UC I E COUNTY, FLORIDA:
This is my declaration of Domicile and Cituenship in the State of Florida that I am fRing this d~ in accordance. and in
conformity with Section 222.17, Florida Statutes.
`I wu formerly a legal resident of ~ 7 _T l1
~ and I
~j _ - / I 7) w 19taW
resided at J ~ ~~1~/"T~~ _ However. I have ehanKed my domia7e b
tStrNt asd Ndmbetl
and am aad have/beea a bona fide nsideat of the State of Fbrida since ~ day d
L~ ~ ,19_~~ and I reside at 7 _ ~ ~'.y
IStrNt a:d Aloser)
P_ C' ~ ~ S T . l UG ! E County. F~oeida.
ccxcl
and this statement is to be taken u my declaration of eitiunship. actual legal resideact and domiale in the State d)F7o~ida.
IF FOR THE PURPOSE OF ENROLLING IF POR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
C iC
J
ST.LtT;,iL CuihT f.F:„_
RQG~A P017R:.S
CCERI! CIRCUIT CG;;i'e
4sx-r7s
I FURTHER CERTIFY that I w91 register at my local address when the e~egiatration books reopen. aad comply with a8
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to amain is
-
- JT . t. U C 1 E .County.
fCity)
Florida. permanenti; .
_
-
A~~
• r.~:
~ ~ 1 .
. ~ ~ .
Sworn to"'' su~lbaerlbed before me this day of
c . A.D.19. 79
RACER PO I TRAS, CLERK OF C i RCU! T GOl~2T
_
ST. LUG I E COUNTY, 1:LOR 1UA~`~ _ ,
EPUTY I.ERK '
R
~
y ~ - t
8!,°.,138 t,r6E.f ~ ; -
~ rn r_.