HomeMy WebLinkAbout1418 D~;~f~rat~on of Domic~fe and Citizenship
464431
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COU~Y, pZ,pg~A;
This is my declaration of Domicile and Citi:enship in the State of Florida that I am itling this day in aeoordanoe. and in
conformity with Section 222.17. Florida Stalutea.
I was formerly a legal resident of ~7/_~ , ~ and I
ICityl / Iiltate)
resided at ~ ' . However, I have changed my domicile to
(Street and NumEarl r T~
and am and have been a bona 5de resident of the State of Florida since ~t,1 ~ day of
L'L n'~~ 19 L , ' and I reside at : ? ~ ~ ~ 1- y
r - 18traat and Numbarl .
t1 ~ ~ L~t?! ~ ST. LUG I E County, Florida,
tcxcyi
and this statement is to be taken as my dec4ntion of citizenship. actual legal residence and domict7e in the State of Fbrida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEtR NAMESS ~
tnt.c~M
Si.ll~Clc Ce+'.:ri Y.ii ~
ROGER P01?RAS
CLEF.K CIRCUii C~ji
464431
i
E I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
j other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no attention to return tom former domicile, and I intend to remain in
U C I E t;~nty,
I Florida, permanenti, .
4
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~ ~ ~ lNamal I
r~~~ -f
' (Addict) ~ ~ !
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Sworn to Tiefore me this day of '~7 /L~~/L ~ - % - J %~L l~C 1
i
~ 9 j~
~'~'0~e` .A.D.19_ ~ ~ ~v~l t'~ ~~~~~r Ski Al11['e I'
~ _
a ROGER POfTRAS, CLERK OF CIRCUIT COURT
ST. LUG I E COUNTY, fLOR t0A
~ '
EPUTY LERK ~