HomeMy WebLinkAbout0779 cl ration of Domicile and Citizenshi
De a p
464036
TO THE CLERK OF THE CIRCUIT COURT.
ST . LUG 1 E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Fbrida that I am 51ing this day in accordance. and in `
oonforaut~? with Section 222.17. Florida Statutes.
I was formerly a legal resident of = 2 ~ C~ ~.H r c i~e t,.l !r -/tC and I
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resided at ~ 7 ~ I ~-2 ~ w ~ • f . However. I have changed my domicile to
IStrNR and Numbrl
and am and have been a bona fide resident of the State of Florida since O c~'_ ~ -e-v ~ 3-~ day of
---19_x, and I aside at ~ 7 '3 's ~ `~1 ~ ~ h~ ~ c ~ ~~'tc~.c
l8te'aat aad IVumb.rl
ST LUG1E
~ ~~fc-`~ _ County. Florida. •
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and this statement is to be taken as my declaration .of citizenship. actual -legal residence and domiei7e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PEASE CHECK:
THEIR NAMES:
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' 464036
I FURTHER CERTIFY that I wi71 register at my local address when the registration hooka reopen, and comply with all
other requirements of a legal resident of this State.
f I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
U C 1 E County.
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~ Florida, permanenti; . _
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~1t~'~is ~•OUNSY•.F~•
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Sworn to and aubsm'bed before me this ~ day of
-
` D 9
~ . A.D.19_ ~ /
! ROGER POI TRAS. CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, FLORIDA ~ ~
'
BY: _
EPUTY LERK
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