HomeMy WebLinkAbout0788 Declaration of Domicile and Citizenship 4
4'71584 ;
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC I E COUNTY. FE.ORIDA:
This b aU declaration of DoadcQe and Citisenship in the State of Fbrida that I am thing this day in aecoedanoe. aed in
oontormity with Section 222.1T. Florida Statutes.
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I was former! a legal resident of ~'`-`-'t~ I
l(tity) (etwl
resided at ~ ~ y9 C~ ~ - Howevsr. I have changed my domic7e to
lStrMt and Nnm~rl
and sm and have been a bona tide resident of the State of Florida since day ~
_ a~ ~ - 19.!
~ - and I reside at ~0~~ ~~~-~d2~~`'z''QJ'`~`~"
~ (8tewt and Noll
_ ~ . U.~c~iu.~ ~ _ ST. LUG 1 E ~ty~ Via,
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and this statement is to be taken as my declaration of citizenship. actual legal residenos and domiede in the State of Flaeida.
IF FOR THE PURPOSE Of ENROLLING IF FOR' HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THE llf!' AMES2
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- a~~ ~9~ JAN -4 Phi 2 54
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F o ~t+o kl:coku~o
- PaTRas ~
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IIFOORa 11EItIftEO
~ ~ 4'71584
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
U C 1 E .County.
~ (City)
Florida. permanenti; . -
s
~ ./I
/p~, ~.-J'~ sir' 04 iL. ~.Clt/tiL~
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Sworn to f ou fore me this ~ day of
Jfi R/ tJ'~+-RBI A.D.1~_
ROGER P01 TRAS, CLERK OF G IRGUt T COOT
X
g ST. LUGIE COUNTY, FLORtOA -
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EPUTY LERK
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