HomeMy WebLinkAbout0518 .rr
/ t
' • • f • ~
Decisrat~on of Domicile and Citizenship
4'71418
To THE cr.Eluc oFTHE CII:CtnT coullT.
ST. LUC 1 E CpU~Y~ FLORIDA:
This is my declaration of Domicile and Citissnship in the State of Fbrida that I am 51tna this day in accordance. and in
conformity with Section 222.17. Florida Statutes. n
I was forme i a kgai resident of h~ i• C' rh n ~'l ~~t ~ T c-51 ~ r~ ~1 Q and I
resided:t _ 1 y ~ o~o. ~ ~ --~'t . However. I have changed ~ domicDs to
t3trMt sai NmmbKl 1.~
and am and have been a bona Sde resident of the State of Fbrida since I ~ day of
~1" ~ ..19
~ q - and I reside at ~ 01 ~r ~ S.~ • S ~ e ~ ~ h .
(Stmt aadNas~b~r)
r~ S~ . ~ l,t e ~ p _ ST. LUG I E County. iF7orida.
(ab)
and this statement is to bs taken as my decLratiat of dtirenahip. actual k3gal residence and domia7e io the State of Florida.
IF FOR THE PURPOSE OF ENROL.L.ING IF FOR HOMESTEAD PURPOSES,
CHIt.OREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
r--
1,960 JAN -3 P!1 IZ~ 35
FI ED AND RECORDED
ST.~IICIE TY.FIA.
CLE~~i;iRC~1~N1T
C~1R
RECORD VERIFIED
4'71418
I FLTRTfIER CERTIFY that I wt11 register at my focal address when the registration books reopen. and comply with all
other requirements of a legal resident of this State.
I FURTH>R CERTII~'Y that I_ have intention to return tom former domicik, and I intend to remain in
~ ~ _ uc ~ F .County. .
i(~t~l '
Florida. permanenti; . '
~ r;;, .
~.~~.~•~~b~~
. (Add~i
Sworn to and subscribed before me this ~3 r' day of ~U,~ T ',-}]''Li ~ ~ i
n A.D.1~_. 1
ROGER
POI~AS.
CLERK OF C IRCUI T Ct3~2T
ST. LUGIE COUNTY, FLOR1 A
EPUTY I.ERK
- g~,~323 ~a~ 518