HomeMy WebLinkAbout0941 Declaration of Domicile and Citizenship
44134
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COUNTY. FLORIDA: .
Tina is my declaration of Domicile and Citisenahip in the State of Flarid: that I sm filing this day in aceordaaoe. and in
conformit~r with Section 222.17. Florida Sta~tu/tes. -
I was formerly a legal resident of _ ~1?' e...~~~~ ~ ~ I
..yy ICttyl (Stan)
resided at ~T_ y,~t~(6ia~..• . However. I have ebanged my domic~e to
(8tnat sad Numbad
and and have been a bona fide resident of the State of Fbrida since day of
19 ~ and I reside at _ ~ ~
l$te+at sad Nnanbar)
~,~:~tJ ST . L UG i E County. .
IUtyl
and this statement is to be taken as my decLration o[ dtizenship. actual legal residence and domia7e in the State of Florida.
IF FOR THE PURPOSE OF ENROIt.ING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOLS PLEASE STATE PLEASE CHECKS
THEIR NAMESS
. J ~ ~ 1
9?9 OC i~ 29 56
F~Lr~? ANC r4:l:liri^t
ST.IUCiE CO:;ltT f.f: A.
ROGER POITRAS
CLER;(GiR~~iT C~~}RTC
- 9~ f
P~f,: ~n
' ~ 44134
I FURTHER CERTIFY that I wn7t register at my local addras when the registration books reopen. and wmply witb aU
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have n intention to return tom tormer domicile. and I intend to remain in
U C E County.
ICxty -
Florida. permanenLi; .
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Sworn to ! before me this 9 day of ~ ~ _ '
tab ~ f~ . v ~f,v ~
d ~ E - . A.D.19.79 C n t,~ c e~
ROGER POlTRAS, CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, ftOR1OA ~ ~
t
EPUTY t.ERK ~
E
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