HomeMy WebLinkAbout0177 -
~.~clara~?~;:.:.. t:~~~~~snsh~p
46'7394
TO THE CLERK OF THE CIRCUIT COURT,
ST . L UC I E COUNTY. F-I,pRIDA;
This is my declaration of Domic~e and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.1T. Florida Statutes.
I was tormerl a resident of ~~~~~1~~~~ and I
..Y ~
` 1(xt~) SState)
resided at . ~ ~ . However. I have changed my domicile to
It'treat sad Nnmt~)
and am and have been a bona fide resident of the State of Florida since day of
Nt}Y ,19~~ and I reside at ~ V O V ~ ~ w~S~rl?~. O~ '
(8t:rat and Nnsnbsr)
S T. L UG I E County. Florida.
I[Sty)
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicle in the State of Florida. i
If FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: ~ '
THEIR NAMES:
s
1979 ,Jt' 28 t~ 34
FILLO FIIC ~l:Cu ,4 v !
Si.LUCIE CGUkTY.FLA. ~
ROGER F'OITRAS
CLERK CIRCUIT ~C'~F'T
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46'7394 ,
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I' I FURTHER CERTff'Y that I will register at my local address when the registration books reopen. and comply with all
other reQuirements of a legal resident of this State. !
i
I FURTHER CERTIFY that I have ao intxntion to return tom former domicile. and I intend to remain in
T. L VG I t - i
.County.
(City) ~
Florida, permanenti, .
Sri
•7 ~i~
J`
'
• _
(Name)
(Address)
Sworn to and subsen'bed before me this day of
~ . A.D.19_
.
~ ROGER P01 TRAS. CLERK OF G I RGU I T COURT
ST. LUCIE COUNTY, FLORIDA ~ '
BY:
EPUTY LERK
~ooK321 P~~ 17?