HomeMy WebLinkAbout0344 !_~'~L.i:- VI L.~l..tlll`_ c'_t lam.! ~itj'L.li5iltU
' 4415643 ~
'FD THE CLERK OF THE CIRCUIT COURT.
S~~. LUG 1 E COUNTY. FLORIDA: .
~ This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance, and is
conformity witb Section ?22.17, Florida Statutes.
~r q G ~S O /7 /l.> :.J ~ ~ BPS zY and I
' I was formed a legal resident of
f l(s/t~) IStiW
resided at ( ~ ~ ~g 4 e / ~ ~ c' 1~ S•J I') _ Aowever.I have cbznged my domicile to
(Street and Number) -
and am and have been a bona Sde resident of the State of Florida since ~ T-~ dal of
- /v v ll. 19_`Y9 analresiaeat 1 ~ ~iJ ~ Z- /~N4~PT f
_-.l~'.P.
(8tsest and Number)
~U ~ S7 L /l ~ / ~ . _ ST. LUG 1 E County. Florida,
_ 1Cat7)
and this statement is to be taken as my declaration of citizenship. actual legal residence and domia~e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOL~•PLEASE STATE PLEASE CHECK:
THEIR NAMES:
s
~ y /~/9 e ~ .~~LL _ ST.LU~IECQtiNtY.Ftd.
ROGER POItRAS
CLERK ClRCI.'IT COi;r~T
_465643
i I FURTHER CERTIFY that I wt71 register at my local address when the registration books reopen, and comply with aD
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have ao intention to return to my former domic~e. and 'I intend to remain in
~ T U C I E , Cot~ty.
_ ((Siy)
Florida. permanenti;.
~o`~~~th
_ - ~~COUt,ITy
(Addr.sa _ ~
Swam to and sobsm'bed before me this ~3 day of U C / c-
' - -
Bt,.Pirs, ~..,l~a-~ 9 - .
-1LD.19
~ ~I _
r
ROGER POIIRAS. CLERK OF G IRGUI T .COURT _
. ~ ~ .
ST. LUGIE COUNTY, fLOR10A
• -
BY: - .r
' _ EPUTY LERK
~ ~ - BGOX J~ PAGE c~`!!~ .