HomeMy WebLinkAbout0369 ' .e-
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46942
TO THE CLERK OF THE CIRCUIT COURT,
ST . L UC i E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am 51ing this day in accordance, and in
conformity with Section 222.17. Florida Statutes. .
I was tormerl a legal resident of ~.4~''YZk-AAA °-J ~ I
IG~ty) IState)
resided at ~ ~ - However. I have changed my domicile to
1 Straat and Nambarl
and am and have been a bona fide resident of the State of Florida since 1? d+7 of
.19~. and I reside at ~ ~~~1-L.I ~ -a ~ - ~ '
(8traat and NmaMrl ~
. ~ ~ ~ _ ST . L UC I E County. Florida.
1(at71 -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domia7e in the State of Florida.
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IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
ST. LUC.- ± ~S LA. I
• P`~C=~
- ~ CLEi r ~ . • BURT
D~ 13 4 06 PM'~~
4b~9432 .
-
I I FURTHER CERTIFY that I wdl register at my local address when the registration books reopen, and comply with all
f other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in .
U C I E _ County.
I 1~j1
Florida. permanenci; .
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{ 7 3 ~ ilC"A Y'~ lJS GUOOd 11/~
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sworn to and sn fore me this ~ ~ say of
a
~ C A,v,rtt ~k~~~}NT J
eceM ,A.D.I9_ 7/
Y ROGER PO I TRAS. CLERK OF C I RCU 1 T COURT
ST. LUGIE COUNTY, FLORIDA
BY:
EPUTY LERK _
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