HomeMy WebLinkAbout0074 D~ciaratiio~ of Do~icil~ a~ci ~itii~c~5i~i~
4'7~3'~53
TO THE CLERK OF THE CIRCUIT COURT.
ST. L UC 1 E COUNTY, FLORIDA:
Phis is my declaration of Domica7e and Citizenship in the State of Florida that I am filing this day in accordance. and is
rnnformity with Section 222.1. Florida Statutes.
.~---J----
Iwas formerly a legal resident of j~!~.EE.~PiS~bvv /~'ir-~~sd -cz' . and I
. City) (State)
resided at ~ ~ s rr However. I have changed my domicie to
(Street and nmberl
and am and have been a bona fide residcnt of the State of Florida since ~ ~ ~ day of
. I9 ?
~ - and I reside at ~D ~ ~ ~i~~'~
(Street and Number)
ST. LUG i E County.
«~cy~
and this statement is to be taken as my declaration of citizenship. actual Iegal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FQR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
TH R NAMES:
~ c i7f
~.~isici// ~:~~~r. 1980 MAR t0 AM it~ 23
S~tE Y. ~A.
q,~ t;~gllT CaNtT
IlEC61t~ YERIf
4'7!x'753
I FURTHER CERTIFY that I .vim register at my local address when the registration hooka reopen. and compb with aD
other requirements ~ a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicie. aad I intend to remain in
- T. U C I E .County,
(City)
Florida. permanend; .
'~4s CO U/yl
=r.
~'`aatalJ:i~' ~ .
(Address)
Sworn to and subsutbed before me this day of _ . _
QQ
A.D.19
~V
ROGER POITRAS. CLERK OF GIRGUI T CO~dRT
ST. ~UGIE COUNTY, FLORtOA
BY: ~ _
_ EPUTY LERK
_ Ilf! ,
E~~»~327 ~~a~E `74 ~ .
S
..:~Y~._ mod.
...A.~.,