HomeMy WebLinkAbout2801 Deciarat~on c..._ ~:n~ ~~tiz~:.~.~~~~~
4~9~?f 0
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E OOUNTY. FLORIDA:
This is my decoration of Domic~7e and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Fbrida Statutes.//~~//
I was formerly a legal resident of _~!'~A.SS / //C~ N ~ ~ / Q and I
(Gl'ty) ~ 181at~)
resided at . However. I have my domicile to
18traat sad Nnmt+ar) ~
and am and have been a bona fide resident of the State of Florid/a since ~ 7 ~7 ~
19~~ and I reside at G ~ ~ ~ - `S
~ 18trNt and Nambar)
~/n-Z~ :.?f lscc_eJ _ ST. LUGIE County, Flar;aa,
_ lute)
and this statement is to be taken as my decoration 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 CHECK: ;
THEIR NAMES:
fIlEO AMD ~:-k0E0
iT. WCIE ~'t FAA.
CtER~..~,::. .oUR
RECORD ~ C
lac i I l0 s6 AN'~~
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I FURTHER CERTIFY that I wt11 register at my local address when the registration books reopen. and comply with all
! other requirements of a legal resident of this State.'
4
I FURTHER CERTIFY that I have no intention to return to my former domicde. and I intend to remain in
z J T . LUGIE _ County.
1(Sty) -
Florida. permanenti; . .
B
.
- , is (Namd
(Aadnaa) ;
sworn to and sub.aibed before me thi: / / day of
o A.D.19_ / 1
ROGER P01 TRAS. CLERK OF G IRGUI T COURT
ST. LUGIE COUNTY, FLORtOA
BY: _ ~ ;
EPUTY LERK -
Bu
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