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HomeMy WebLinkAbout0817 ~ ~ Deci~r~tion of D©micile and Citizenship 4'7160'7 TO THE cI.ERx oFTHE c>~tcurr covRT. ST. LUC 1 E apUNTy, FLORIDA: Thin is my declaration ~ Domiei7e sad Citissnship o the Scats of Florida that i am Shag this day is aoooedaaos. std is coafarmity with Section 222.17. Florida Statutes. I was former a legal resident of - sad I lCitjl (St~t1l resided at ~ v However. I Gave changed my domict~s to (Stns umbK) ~ / and am sad have been a bona fide resident o[ the State of Florida since day of i ~ 19 and I r+esids at ~ ~ ~ D ST. LUG I Estnc.aaNo~l --c_ ~ ~ County. F'larida. 171 and this statement is to be taken as my decoration of citizenship. actual legal residence and domicile in the State of Florida. - s IF FOR THE PURPOSE OF ENRO!lING IF FOR HOMESTEAD PURPOSES i CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: THEIR NAMES: x- 1980 JAN -7 AM ~ 55 - - f D AND AftppkU[0 / S1~~IE COt~11TY.FlA. ~~`e o~ITReS ClEAK ClRClNT COU~~ RECORB VERIF:f'J~ 4~sso~7 I FURTHER CERTIFY that I w~71 rcgister at my local address when the registration books reopen. sad comply with alt other requirements of a legal resident of this State. I FURTHER CERTI>~'Y that I have no intention to return to my former domicile. and I intend to nnuin is U C 1 E ~ County, _ (Qty) Florida, permanenci; . s• . ~ r ~ y r 3 i'!: ~ i ~ V (Addew) Sworn to and spbscn'bed before me this ~ day of ' o A.D.19~,....__ ROGER P01 TRAS, CLERK OF C IRCUI T COC~2T - ST. LUC I E COUNTY, f LOR i DA - 8Y: ~ EPUTY LERK 3~'3 ~E 817