HomeMy WebLinkAbout1127 a ~
Deciarat~on of Dom~c~ie and C~t~zenship II
To THE cl.>;RIt of THE clRCVrr covRT, 4 X1168
J ST . L UC I E ~ OOUN'1'Y. FLORIDA:
This is uq declaration of Domidle and Citisenship in the State of Florida that I am 51ing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formers a legal resident of ` . n ~ ~ C, ~J r ~ ~ and I
(a~y~ (sw,.)
resided at N . However. I have changed my domiei7e to
(StrMt gad NaoDsN _
and am and have been a bona 5de resident of the State ai Florida since n ~N ~ ~
,192.. and I reside at 2 3 O lp S~4 ~ ~1-~ i e~ u ryu G. -
(Strwt sad Namb~d
1=~- ~ie~-c-~ ST. LUC I E qty.
(sal
and this statement is to be taken as my declaration of citizenship. actual legal r~esidenoe and domieDe is the State of Florida.
-'IF FOR THE~PURPOSE OF ENROLLING If fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NANESt
~ - 4~'i168
~,~tt 28 h a9
IEC~Tk
~cn~ant ceu~1 l
_ ~
` ~~A1ftLQ
~ I FURTIlER CERTIFY that I w~71 register at my local address when tha registration books reopen. and comply with all
other requirements of a legal resident of this State.
I FURTIiER CERTIFY that I have no intention to return tom former domie~7e. and I intend to remain in
_ t . ~ u ~ ~ ~ County.
IRty) - -
Florida. permanents; .
4~AN '
:u 1
YY ~J. ~ G
' ~
~ f r _
~ G
~NI::: (Name)
• aZ3C?(o SRN ~0 17y ~
Sworn to and su 'bed before me this ~~day of
Q^ 'h c~ ~
l L~ A.D.18,~~ b~-er~r E-j e ~ l .
RpGER P01 TRAS. CLERK OF G IRCU1 T CO~dItT
sT. LuG1E couNTY, FtoR~oA
BY •
• c
E P U T Y J E R K dURI PAt~
AGO Form ?t 7l
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