HomeMy WebLinkAbout2482 Declaration of Domicile and Cit~zensh~p
463155
To THE cLERx oFTHE ciRCU1T ooURT:
ST. tUG 1 E CoUIVTY~ I,•I,p~A;
This is aq declaration of Domip7e and Citizenship In the State of Florida that I am Slim this da,T in aooordanee. and in
ooaformit~ with Section 222.17. Florida Statutes.
1 was forme 1 a legal resident oz ~ d~~G-~? _ ~ I
lat,~ Istatd ~
resided at ,~~L~t'.c l~~ /l~~c~o
~ Aowever. l have ehanaed mIr domicils to
18traat asd NnmbR) pp~~
and am and have been a bona fide resident of the State of Fbrida since - [ ll X . % ~ o{
19_„ and I r+e:ide at ~ ~ ~ ~~r,c.
tract and Nnmbar)
~ ST . LUG 1 E CountT~ Florids.
(Citj)
and this statement is to be taken as m~ declaration of citizenship. actual legal residence and domidle in the State d Florida.
IF FOR THE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS
1919 ~~T 19 A~; i l : 14
_ FIIEO AtiC kE~uKl:t'D
S R06ER
PO
TRASA•
CLERK CIRCUIT COCR
RrtrRO ~'EPif E'1__ ~ _ -Ca.--
463155
I F[JRTHER CERTIFY that I wt71 register at mT local address when the registration books reopen. cad oomplT with all
other requircmenta of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remait? in
U C E C~7.
ICit .
Fbrida, permanenci; .
~ 1
~auN~ ~/q.,r v ~d ~elv~ J ~:5 ~ ~ ~
`v
lei.. ~'-L. Y____. .
J
Sworn to and sabstribed before me this -__L~ dar of / 1 ~ ~ 1~ L~._. ,~cn
~c .~.D.ls 79
ROGER
POI~AS.
CLERK OF' CIRCUIT COURT ~
ST. LUGIE COUNTY, FLORtOA _
-
BY: ~
. EPUTY tERK •
k . _ ` _
2475
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