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Declaration of Domicile and Citizenship
- ~ 4?~15"T7
TO TILE CLERK OF THE CIRCUIT COURT. .
ST. LUC 1 E COU~y~ Fi.01itIDA:
This is my declaration of DomieDe and Cttizenship in the State of Florida flat I am filing thin day in accordance. and In
conformity with Section 222.17. Florida Stdutea.
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I wu former a legal resident of K~ 0~ ~ ~ ~ - ~t- ~ ~ _ and I
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resided at ~ ~ ~ . However. I have changed my domicile to
- (8tn~t and Nambd
and am and have been a bona fide resident of the State of Florida since ~~n ~ ~ day of
.mss
19~. and I reside at ~ '~11~ / y~ ~/1~ S4~L~1 / ~~c ~ l~~
lshwt.aaN -
~-~Sj~, ~ , ST . LUG 1 E County. Florin.,
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and this statement is to be taken u my decLration of citizenship. actual legal residence and domia7s in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMESS
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_ 19b'0 JAN -8 A~ , 03
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_ aERn clRant
c~oul
RFCOR!1 ~'EPIfK'b~.
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I FUR'rIIER CERTIFY that I wi11 register at my local address when the registration books reopen. and comply with all
E other requirements of a legal resident of this State.
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i I FURTHER CERTIFY that I love no intention to return tom former domicile. and I intend to remain in y
U C 1 E ,County.
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~ Florida. permanentl; .
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I;,p(;NTy
J t BOG
E r • (AddrMS) ~
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Swore to and subscn'bed before me this o day of ~ q~ _k=/~
.l V 0.R A.D.19~-. 4
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ROGER P01 TRAS. CLERK OF G I RCU I T COt~tT
ST. LUG I E COUNTY, F>_OR 1 DA
EPUTY LERK
~ ~ ea~c323 P,r~~.212 .
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