HomeMy WebLinkAbout2729 i - .rr
~
.e i ~ ' ' • ~ ti
Declaration of Domicile and Citizenship .
• 4 `~8n4
TO THE CLERK OF THE CIRCUIT COURT. .
ST. LUC 1 E COUNTY. FLORIDA:
This L ~ declaration of Domkik cad Citiseaship In the State of Florida that I am ~ this dq in sooord:aoe. cad is
conformity with Section 222.1?. Florida Statutes..; ~
I was forane a legal resident of - ~~t~~-~:/C cum Q-G~Q _ ~L~ • •NG;'~.~ and I
resided at ~ So • - However. I love
ehaaged my domicile to _
i8teNt asd NambKl -
and am and have been a boas fide resident of the State oI Florida since ~.~.cr day of
/ .19 cad I reside at ~9~i~z? ~~rzl/ Gam- '
(8ttwR cad Nostb~d _
c~~ _ ST. LUG I E Connty, F7ocids.
e,
Icu,~
and this atatement is to be taken as my declaration of citizenship. actual legal rssidenee and domide is the Sots of Florida.
•
If FOR THE PURPOSE OP ENROt.t~ING If
FOR HOMESTEAD PURPOSESa
CHILOREH IH SCHOOLS PLEASE STATE PLEASE CHECK:
THEIR- AMES:
J''/
_ _ ~sao SAN ~ s ~ r o2 ~
4
r
- FILED AIiD RECUk0E0
` ~ §T.LUCIE000NTY.FIA.
_ ROGER POITRAS
CLERK CIRCUIT C04 T
~ RECQRC Y~FtfiCJ
- ~~zso4
-
I F4JR1'IiER CERTIFY that I w~71 register at my local address when the ngistntion books reopen, and comply with all !
other requirements ~ a legal resident of this S4te.
i
I FURTHER CERTI)F'Y that I have . no intention to return tom former domicile. • and I intend to amain is
_ U C 1 E . Coanty.
((:d7) •
Florida. permanead; . •
- -
i
' f - ~ t'' • r
• - : a
L (Add:er~l
Sworn and subsen"bed before me this / V day of
Q
- ~ -cam A.D. to y~
{
RO POt AS C K OF C If~CUI T COC~2T
ST. LUGIE COUNTY, F~~21DA
BY: ~ •
EPUTY LERK _
- _ 1~R PAGE~~~S •
' - - acox