HomeMy WebLinkAbout0068 Declaration of -Domicile and Citizenship
4b~0500 .
TO THE CLERK OF THE CIRCUIT COURT.
ST. ~ UC 1 E C`d1UI~T'Y, 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. /
I was formerly a legal resident of T ~,Le m I ' ' ~ ~ and I
((tity) (stag)
resided at ~3e f17 ~ e rrl . However. I have changed ~ donoic~e to '
lStseet and Nnmbad
and sm and have been a inns fide resident of the State of Florida since ~ 3 ~ ~
~ r C:- 1'l .19- and I reside at J t e. ~ ~ ~
n (street and Number)
t~.~ ~ /1 i c~ he_ I1Q U e n.~ j~~ . f~ prrr~ ST. LUG ! E Cw,nty, Florid,,
«~1
and this statement is to be taken as my declaration of citizenship. actual kgal residence snd domicile iA the State of Florida. i
If FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSESi
CH LLDREN 1 N SCHOOLa PLEASE STATE PLEASE CNECK2
THEIR NAMES: ~ -
f
1/ ~ E ilJ ' ~ 1 `E
1980 MAR 24
FtlEO AkC RECOROEO
3 t11CtEC0UNJY.it~, .
~OGER Pp~TlIAS ~
- +tf1tK Ci~~
VERtF1f0
48050U
I FURTHER CERT'll~'Y that 1 wi11 register at my local address when the registration books reopen. and eomp~y with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicRe. and I intend to remain in
- - _ _ _ U C 1 E .County.
((Sty1 _
Florida, permanensl; .
t
_~_Mq~ f
J ~~G -
v :
m~, Q~°P (Name)
~G~'f courtt+ 3 `f'~ ~ ~ 9~ /IAJ eN ~d .
- (Addreesl n
Sworn to and subscribed before me this y dsy of S, e S 7A A,, T e / ~ j - 1
J i C RC P
ROGER POI TRAS, CLERK OF C IRGUI T CO~tT
ST. LUGIE COUNTY, FLORIDA
BY:
EPUTY I.ERK-
8328 6$
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