HomeMy WebLinkAbout2050 . fli~iC11 Ca.?` L? _`i,?1~~~111i C~??U L/elf ?.:Jil~lJ
44i~838 /
'FD THE CLERK OF THE CIRCUIT COURT.
S~. L lJG 1 E CoUA'TY. FLORIDA: ,
_ ,
4'his is mT dedaratioa of Domia7e and Citizenship is the State of Florida that I am filing this daT in accordance. and is
conformitT with Section 2?1.1?, Florida Statutes.
~t p ~ n 1 y~ ' and I
' I wu former) a )egal resident of . /l I~ l " K IJ . ~
~ (~t~) (Blase)
resided at 1yy 7 ~i9 C~ /n ~ S _ No.vever. I have changed mT domicde to
(Street and Number)
and am and have been a bona Sde resident of tht State of Florida since DC~o 6 e d' .3 % daT of
. 192,. and I reside at ~ ~ ~ / , / ~/,-S C S / ' y~ _
(3treet and Nnmbv) '
~ ~ e r C ~ ST . L UG I E CountT. Florian.
(cslT)
and this statement is to be taken as my declaration of dtizeaship. actual )ega) residence and domia7e in the State of Florida.
IF t'OR THE PURPOSE O~ ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL,-PLEASE STATE PLEASE CHECK:
THEtR NAMES:
,~b /7`I ~ D ~ Y t ' ~ ,S
s
~ ~
F ilEt~ ftit ~
SI.II:CiF C^'. N*'f.
~~1~.~1t t'l)t1 Y iti:~
CIEP.C C;R:u!I C:
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. 4~;~838
i
I F[TRZ'IlER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
f
~ other requirements of a )egal resident of this State.
I
I FURTFIER CERTIFY th:t I have ao intention to return to m_v former domic~e. and I intend to remain in
T U C I E _ CountT.
~ ICTtT) _
Florida, permanenti~_
_ _
~ CU UI!jT~ ~
r~ r E}! r
.
Sworn to an ~s'bb~"bcd before me tha ~ day of ~ ~ ~ r C- .
srt"lL~~ , . A.D.19
~ C ~RD9~ ~8T t 1I
ROGER POI TRAS, CLERK OF G 1 RGUI T COURT _ ,
ST. LUGIE COUNTY, FLORIDA `
' - - ~
BY: -
' _ E PUTY LERK