HomeMy WebLinkAbout0319 .
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4~i'7489
TO THE CLERK OF THE CIItCUIT COURT.
ST . L UG I E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship is the State of Florida that I am filing this day in accordance. and in
rnnfogtaity with Section 222.17. Florida Statutes.
I was former~~ a kga! restdeat of ^ ^ ~ ~ n -r ~ and 1
~ I~t lState)
resided at ~~J 3~• ~A tJLS • _ . However, I have changed my domicile to
(3treet and Numbsrl
and am and have been a bona Sde resident of the State of Florida since a S -day of
O ?LC ~ !g ~ /P r 19~~. and I reside at `3d / ~ ~ o ~ o ~ 1 ~ F
(Stebst and Number)
F~ 2r ~i~~e ~ ~ ST. LUG I E County. Florida.
(ISty)
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKI
THEIR NANESL
if
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ROG'IrR !'~iTF::~
4~?'~489
I FURTHER CERTIFY 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 no intention to return to my former domicile, and I intend to remain in
T. U C I E .County.
ICity)
Florida, permanenti, .
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~OU1VTy /
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' It f ~ ~ . ~ -r - (Name?
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Sworn to and subacn before me this ~ day of ry R? / /6 ~P~ 6 A _
F - 1
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DUo~r2 ~ .e,P . A.D.19_ ~1 l3eOiQ9 e v INK ow ~ TZ,
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ROGER PQITRAS, CLERK OF CIRCUIT COURT ( CeC~IiA.
ST. LUGIE COUNTY, FLORIDA
BY: - .
EPUTY LERK
32~ P~~E 3~9 . _
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