HomeMy WebLinkAbout2828 Decla~•~..- _ .:y ~zicil~ ane~ ~ ..i~anshi~ ~f J
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TO THE CLERK OF THE CIRCUIT COURT.
ST L UC t E COUNTY. FLORIDA:
This is my declaration of Domicile aad Cttzenship in the State of Florida that I am filing this day is aooordaace. and in
conformity with Section 222.17. Florida Statutes. /
I was forn?er~ a legal resident of ~ - ~~O ~ a a aad I
CC ~ 1Cit7) 18tat~l
resided at S Y f~ .zl~er ~ . However. I have changed my domicile to
13tiyat and Nameat)
and am andlhave been a bona 5de resident of the S4te of Florida since f ~ S ~ ~y ~
~ Ill -19~~ and I reside at 1 ~ ~9 f
• ~a ~1 Ord ~d I -
(BtrMt sect Nombae)
~Dr t Sa 1 ~ ~.u c~_) Q _ ST . lUG I E County. Florida.
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snd this statement is to be taken as my deeLntion 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 GHECK2 -
T H E I R N A M E S t 1-----~
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FILED Are ~ - .:;!)EO
110{::' :S
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I FURTHER CERTIFY that I w171 register at my local address when the registration books reopen. and comply with all •
other requirements of a legal resident of this S4te.
E
j I FURTHER CERTIFY that I have ao intention to return to my formerlc_le. and I intend to remain is '
I J T. 1. V 1 L COnnty.
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Florida. permsnenti; .
e
$ - s.
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` Sworn to aad snbserbed before me tbia day of ~
9
~~~M b eR . A.D.19
; C~ Qa0. N Y. r I S ~ d N>
ROGER P01 TRAS. CLERK OF CIRCUIT COURT J~3 o S. CHN 0 !'H ~d
ST. LUCIE COUNTY, FLORIDA .
EPUTY LERK
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