HomeMy WebLinkAbout2701 i ~r
~~otara~~can Q~ Domiciled and c.~ ~
468996
TO THE CLERK OF THE CIRCUITCOURT. -
ST. LUG 1 E COUNTY. FLORIDA;
This is my declaration of Domip7e sad Citizenship in the State of Florida that I am filing this day in accordance. sad in
coaforatity with Section 222.17. Florida Statutes.
I was former a kgal resident of ~ ~ ~ ~ ~sc__ ana I
~R ICtlyl )
resided at ~ /~-J~2~?''t- - However. I have changed my domicile to •
lStnst sad NumD~r)
and am sad have been a bona fide resident of the State of Floridasince d+7 ~
19~. and I reside at '~`z`"~'
' C~ ~ nmtw)
~ ~.f'1; ST. LUG I County. Florida,
t(~tyl
and this statement is to be taken as my declaration of citizenship. actual kgal residence sad domic~7e in the State of Fbrida. •
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES!
~T.lUC1E .
RCGEr•• ~~RT
CLERK- ~
- - - Doc 10 3 si P?+'~
4'b8996
I FURTHER CERTIFY that I wi11 register at my local address when the registration books reopen, and comply with all
other requirements of a kgal 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
_ J T. L U 1 t . COUnty.
'i tCity)
Florida. permanenci;.
4 ~
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~~~Nr ~71~ i
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GC i i' i 37
V`~~ ccueiv.~~ t
sworn to before me this l Q day of Po RT . S?. C- yC i e 33 ~ ~o~
s
9
~ C ,64~P , A.D.19_ T7NNiI' o~ STeP /7tAJ I
~i4 d
Y~
ROGER PO i TRAS, CLERK OF C 1 RCU 1 T COURT
ST. LUC I E COUNTY, f LOR 1 OA
~ BY : -
EPUTY LERK
- E~ 32~ PEE 2697