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HomeMy WebLinkAbout1157 ...:~ara~ic~n c~ ~as~nicile and Citi = L... s ~ ~ ~ssoos TO THE CLERK OF THE CIItCUIT COURT. ST . L UG I 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 in conformity with Section 222.17. Florida Statutes. I was former a legal resident of ~_r~,o and I estate, resided at ~ , However, I have changed my domicile to tstrNt sad Nnadse) and am and have been a bona fide resident of the State of Florida since ,~/~//4.J.. day of 19~ and I reside at / d ~o LL^?~•C~ ~r ~ (Strad sad Namt+wl County. Florida, ((xt,l and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State ~ Florida. IF FOR 7HE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, CHII.OREN IN SCHOOL, PLEASE STATE PLEASE CHECKS THEIR NAMESS fLED AN.i • ' ~l~pEO IUCIC . ~'i! • FLA. - ~ CLEQK i. ~ i c:?U T ~ _r _ DES 3 3 ~o PN'?! 0 . b?s0 8 4 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 FURTHER CERTIFY that I have ao intention to return to my former domicile, and I intend to remain in _ _ U C 1 E County, ICi~y) . Florida, permanenti; . t i r ~ Y i F,. . c_~ r-- ?fir i' /~i~2c~i sworn to and before me this 3 say of ~c4 ~ ~yc.~ ry oYtM ! v¢.(Z . A.D.19_ ~9 C L- d,ur R eN C E Ca. R ~ Y~ RQGER POITRAS, CLERK OF CIRCUIT GOURT N/N/~ C,gR~~ ST. LUGIE COUNTY, FLORIDA BY: • EPUT LERK ' e~~x 321 ~~~E i1~6