HomeMy WebLinkAbout0436 M-
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D~clara~i®~ of Dorr~ic~l~ end ~itii~~n5i1~~
4'x'7021
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG ! E COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance. and in .
conformity Witb Section 222.17. Florida Statutes.
I W as formerl a legal resident of ...~i N ~ and I
(Ctt~l tStaW
resided at ~ ~ ~ IioWever. I have chaag+ed my domie~le to
(Stesst aad NomD~y ~ ~
and amandhave been a bona fide resident of the State of Fbrida since d~ ~
,19~ and I aside a!
(Street aedNnmbar)
~C? i~T V G.1 C _ ST . l UG t E County. Florida.
tC~U?1
and this statemeat is to be taken as my declaration of eitizenship~ actual legal residence and domicile in the State of Fbrida.
!F FOR THE PURPOSE OF ENROLLING !F FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NANESS
_ ~J ~pN E~
_ 1980 FEa 25 A~; 38
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_ ST.LUCIE COUH7Y.ilA.
ROGER POiTRAS
CLERK CtRCUR CIIU~i ~ - -
4`7'7Q21 3
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I FURTHER CERTTFY that I wiII register at rep local sddresa When the registration books reopen. aad oompl, With all i
other regninments od a legal irsideat of this State.
I FURTIIER CERTIFY that I have no intention to return to my former domicile. and I intend to remain is
T. U C I E ,County.
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Flonda. permanentl,'. i
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SWOrn t0 and ftibses'ibed before me: this ~ da, Of_ ~ • t
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RQGER ~ PO! TRAS, CLERK OF G ! RGU I T CO~F2T
ST. !E COUNTY, FLOR DA -
BY;
EPU7Y LERK ~ -
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