HomeMy WebLinkAbout2942 Declaration of Domicile and Citizenship ~
4639;59
TO THE CLERK OF THE CIItCUIT COURT,
ST. LUG 1 E COUNTY. FLORIDA:
Thin is my declaration o! Domicile and Citizenship in the State of Florida that I am fling this day in accordance. and in
conformit~? witb Section 222.1?, Florida Statutes.
I ~ ~ / ~J ~ and I
I was formed' a legal resident of ~ -
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resided at ~ E' f`- A V . However. I have changed mJ domicile to
(3trNt sad NomD~r! ^ L
and am and have been a bona fide resident of the State of Florida since ;
l U n~ d+y ~
r .192L. and I reside at T_
~ (Strut sad Nombt)
PO 1Z ~ ~ ~ ~ C ~ +L _ ST . L uc I E County. Florida,
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sad this statement is to be taken as my declaration of atizeaship, actual legal raidenee and domicile is the State of Florida. -
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE- PLEASE CHECK:
THEIR NANESI
-?Z R.' A 1~ ~e_ ~ A K~ / ti` p ? 1319 OAT 23 Pr: 13
FILED ANC' FECI:r'cU
5 ROGER
PolTtias~-
CLEP.K CIRCiJIT C~O~'.T ~
463459
I FURTHER CERTIFY that I will register u my local address when the registration books reopen. and comply with all
other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
. U C 1 E County.
4 (Cktyl -
Florida. permanents; .
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1 iC ~ (Name)
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(Addr+aa)
Sworn to and subsen'bed before me this ~ day of
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1 9
e , A.D.19
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ROGER P01 TRAS. CLERK OF G 1 RCU I T LOURT
-
ST. LUGIE COUNTY, FtORtO
'
BY: - _
EPUTY IERK - -
_ - -
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318 y
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Af,O Fnrm 71 ~