HomeMy WebLinkAbout2599 _ ~
cl rat~cr~ of Domicile and Ci~~zenshi ~
De a _ p ~
- 4'4850
700 TAE CI.ERR OF TAE CIRCUIT OOURT. i
STS LUG 1 E COUNTY, ~,p~A; '
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~ ` T!w is m,7 deeLration of DomieDe aad (~iti:enship in the State d Florida that I am 51ins this dq is sooordaaee. atiad is
_ ooaformitj with Section ?22.17. Florida Statute:.
' I was fob a legal resident d - -ll ~ I
raided ~ ~
9,TT~ ;
o ~ t~P h vP - However. I have changed mT domie~e to
IStr.~t aad Nmab~sl _
aad am and have been a bona 5de resident d the State d Florida since ~-Q-~r daT,~d
t~r-l
o ~iv P ,19 and i reside at _ ~6 Q 9 E• L~ o w : ?7 ~y ~'9 c/ ~
tsa..a..a Namb.rl
~~~5 T ~ uu ~ _ ST. LUG I E
ICibl `
and this statement is to be taken as m~ declaration d citizenship. actual legal residence and doaude in the SLte d F7arida.
IF FOR THE PURPOSE Oi ENROLLING IF FOR HOMESTEAD PURPOSES, t
CHIIOREN IN SCHOOLs~PLEASE STATE PLEASE CHECK:
THEIR NAMESS
{
1919 OEC 28 A!I ~ 46 ~ ,
f~.E~ REC ~ lA.
Ct,ERK CIRCUIT ASTr
RLCt31~ YERIFIEp--1~
4'70850
j I FURT~R CERTII''Y that I w~ register at mT local address when the registration boob reopen, and oomph-with all
other regairements d a legal resident d this State. ~
I FURTHER CJ;itTII~'Y that I have no intentioa to return to m~ former donueHe. and I intend to remain in
T U C E Count,
_ tt~trl
Florida. permsaentl;.
.
~ i
_
. , ~zYt o
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Swore to and snberncribed before me ~jt% ` ' ~Z a daT d
1 C-~.~ , ~-9 - _ _ e
. A.D.19
~ e~ Maw
P
ROGER POIIRAS. CLERK OF C IRGUI T COURT
ST. LUGIE COUNTY, FLORtOA _ - _
• .t.
BY: _
' EPUTY LERK QR ~ -
t ~ ~ suoit3~ PacE2~. - `
r - - -