HomeMy WebLinkAbout2703 D cl r ti n ' ' ' '
e a a o of Domicile and Citiiensh~p
4b~0294
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC I E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am Sling this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
l was formerly a legal resident o1 - I`f e ~.y ~ .f cttit~~ ~ a- and I
ICYt~1 13tatN
resided at . However. I have changed my domicile to
and NumDr) p
and am and have been a bona Sde resident of the State of Florida ainoe ~ / ~ ~ day of
19_,.. and I reside at ~r
? ~ / ~ r~ ~ e e~~
~o r~ n ' lstr..t aaa Nnme.r)
e v-c e ST. LUG i E County. Florida,
tc~cy)
and this statement is to be taken as my decLration of citizenship, actual legal reaidence and domiale in the State of Florida.
IF FOR THE PURPOSE OF ENROILlNG IF FOR HOMESTEAD PURPOSES,
CHILDREN !N SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAkES:
1980 MAR 20 PK 2 41
FLIE~D
1? QECOg0C0
ST~06ER~P~TRA~A~
CtERI(gRtUIT COUlT~
it£CdRt VERIF".FQ_ ~ -
46iU`' 4
I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and 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 I E .County.
ICYty)
Florida. permanenu, . •
- /
~ _
- ~ ` : INaaoa)
-
(Addt+w)
Sworn to and subsrn-bed before me this ~ day of
OVt~ .
, A.D.19~._i.
ROGER P01 TRAS. CLERK OF G IRCUi T COC~tT
ST. LUGIE COUNTY, fLOR1 -
.3
EP-UTY LERK
6~tN Pt~Gf~~ -
. d. _