HomeMy WebLinkAbout0889 Declaration of Dom~c~le and C~tizensh~p
4'1648
To TIIE cI.ERIC of THE c>~ICUrr covRT, -
ST. LUG 1 E CovNTr, FLORIDA:
This is my declaration of Domicils aad Citvsaahip in the State of Florida that I am filing this day in acoardanos. and Ia
coaforauty with Section 222.17. Florida Statutes.
I was formed a legal resident of ~ ~2 ~ ~ ~j ~ ~ ~ Z u ~ ~ d- and I
(City) IStat~)
resided at a ~ ~ L- ~ ~ ~ QTe ~ ~C1 t ~K d - Q 1 Z . However. I have changed ~ domicile to
IStr~at aad Numbr)
aad am aad have been a bona fide resident of the State of Florida since day of
~ _
I / ~ L ,19 and I r4side at S (~J jlt.1 n ~ 1 . 2 2 2
(Stewt and Nambar)
Q~ ,~r ~ L 1 ~ G 1 P ~ ST . L UG I E County. Florida.
caty~
and this statement is to be taken as my declaration of citizenship. actual bgal residence and domicile in the State of Florida.
if POR THE PURPOSE OP ENROt.t.ING IF fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK2
THEIR NAMES:
~1yQ1~~ L~Sc gr7 a
L o S C,~ l.980 JAN -7 Il~f ! I= 3S
FILED ANO RUECUROtU
S
ROGER
POITRA5
CLERK CtRCUtT
;Otltt~~
- f-
4'1648
I FURTAER CERTIFSI that I w71 register at my focal addras when the registration books reopen. aad comply with all
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 1 E _ County.
1(St~l -
Florids. permaaeati; .
~ OOUNly~b~~
e
J ' _
V ~ _ -
[t
Cds
s~ ' _ INama)
.
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Sworn to and subsen-bed before me this / day of ~J N 1 ~ Z Z.- Z ~ ~ ~ ~ UC~~
~A N U Cl Rte/ A.D. ls~_ ~N R!Q t! ~ ~ 0 S C h ~
C `
ROGER POI TRAS, CLERK OF G IRCU! T COf~2T ~d a/ S%DoN jA
ST. LUCIE COUNTY, FLORIDA
BY• ',i`~
• l N
EPUTY LERK
gppXe~,'~~c PAGE 009