HomeMy WebLinkAbout2012 l„Jl:;l.tG:t ~ ~ _ VI ]Jl..l„'•.,.... c: t~.~ ..)'_l.:i:.,.lJ
'FO THE CLERK OF THE CIRCUIT COURT.
S~. LUC 1 E COUNTY. FIARIDA: .
This is my declaration of Domici]e and Citizenship in the Stale of Florida that I am filing thin day in atxordance. and in
coaformit, .vitb Section 222.17. Florida Statutes. /n~ M
' I w_u formed a ]ega] resident of ~ ~ ~ lo? ~Q~ ~C ~ ' ^J and I
resided at - floWever, I have changed my domicile to
IStreet and Numbed
and am and have beta a bona Sde resident of the State of Florida since J ~ da7 of
_ ~`.J ~ ~1_~,.1~..19~~ and I reside at Z¢~S • O C E/~N ~1(tQ1 V E. GC~'F V tl•4 A S~-I Z
(Strut and Nnmberl
' ~OVQT• ~ 1 ~ R~ ST . L UC 1 E County, Florida, ~ .
(cstyl
and this statement is to be taken as my declaration of citizenship. actua] ]ega] residence and domia'le in the state of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL~PLEASE STATE PLEASE CHECK: J-~
THEIR NAMESS
: ~
- - l9T9 t~0'1 20 i'~i 12~ 12
FILE[) ANC ~Ur:U: J
ST-ll;Cl~ CCU~TY.Fi A.
- ROGER POtTRCA ~T
CLERK Ci~?CUI i
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4sss3z
.
I F[JRTHER CERTIFY that I will register at my local address when the registration books reopen. and comp], with aD
I other regnir+ements of a legal resident of this State.
i
I F[JRTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
i T. U C I E ,County,
_ ICity)
Florida, permaneau~.
- _ _
T
~ v• Can f ter r ~ pp~~~ ]~/~,,r • ~/r!
F • v J' ,
s..arn *Q and su --before me this o? ~ aa, of r• /L° heQ
dV t ~(Z , lLD.19
~
ROGER POITRAS, CLERK OF CIRCUIT GOl~2T ~Ov~Se Sf~Vage `r • ~
- _ .
ST. LUGIE COUNTY, FLORIDA
_ ~ - ,
BY: ~ -
' EPUTY LERK
• ' OR f)t)0 Ahl
~ J~ i
• BOOK P
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