HomeMy WebLinkAbout0047 J
• /
~ ~ • • ~ ~
Declaration of Domicile and C~t~zenship
480483
TO THE CLERK OF THE CIItCUIT COURT.
ST. LUC I E COUNTY. FIARIDA:
Tbis is my declaration of Domicile and Citiseaship in the State of Fbrida that I am Ring this day in accordance. and in
conformity with Section 2?2.17. Florida Statutes.
I was fob a legal resident of ~ F U _S ~ ; 1 ~ i ~ ~ ~ sad I
n 1(Sty) ~ l3tate) _
nsided at gsZi ~
f V ~ ~ t ~ ~ ~ - Ao~vever. I have changed ma domic~7e to
IStrs~t sad Hambt)
and am and have been a bona 8de resident of the State of Fbrida since ~ ~ a ~ T .day d
- w.
`]Y~.y~i .19~1Z. and I reside at 3 d R /~S~ T~
(3trMt sad Nombw)
~ 17 ? ~ R C S T . l UG I E County. Florida, •
lat,~
and this statement is to be taken as my declaration of citizenship. actual legal residences and domiei7e in the State oI Florida.
i
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CNILDREM IN SCHOO_Ls PLEASE STATE PLEASE CHECK:
THElR NAMES:
~c~ I~ E ~ yr? r e h~lc C~ frt~ rn A/~Rit' S -
19$0 NAR 24 A!I ~ 19
ST
l E
OUNTT~f A,
ROGER POiTRA~
_ q.ERK CiRCtNT Cd{1R
RE61411E VERtftEO"1?_.._._
480483
I FURTHER CERTIFY that I wdl register at my local address when the registration books reopen, sad comply Rrith all
other requirements of a legal resident ~ this State. '
I FURTHER CERTIFY that I bave no inteat3oo to return tom former domicDe. and I intend to remain in
U C 1 E .County,
IfSt~)
Fbrida. permaaenti, : -
,:~:.:r,l~i
- ~ - -
Sworntto aril'.t~s~'bed before me this ~ day aI (Addrea.)
A.D.1 ~
R PO AS Ct_ERK OF IRCUI T CO~tT
ST. L E COUNTY, FLORIDA
BY: •
EPUTY LERK
~~328 PEE 47