HomeMy WebLinkAbout0245 • .u
Deciarat~on of Dor~ic~le and C~t~zensh~~
42415
TO THE CLERK OF THE CIRCUTf OOURT.
ST . L UC I E Cpv~y, ~,ORIDA;
This is my declaration of DomicDe and Citizenship in the State of Florida that I am 51ing this day is accordance. and in
conformity with Section 222.17. Florida Statutes.
I was former a legal resident of ~'N a~ I
. lCit71 Stw)
resided at - _ However, I have changed my domieDe to
(8~t sad Nmbr)
. and am sad have been a bona fide resident of the State et Florida since I - - - ~ S r day of
V 0 y~ M B~ 2 ,19~. and I reside at I "1 3 2 ~u;,,i. ~4 k3 Y 1 ERR Ac f_
(tltrMt sad Noaib~rl
ci -r ~T. U C t ~ ~ ST . L UG I E County, Florida,
ccuyl
and this statement is to be taken ss my declaration ~ citizenship. actual legal residence and domic7e in the State o[ Florida.
IF FOR THE PURPOSE OF ENRO~t.ING IF FOR HOMESTEAD PURPOSES,
CH 1 t.DREN 1 N SCHOOIa Pt.EASE STATE PLEASE CHECK:
~ THEIR NAME8:
~sao apt -s ~ ~i: ~o
- - ST. LEUCIEE
COUNCTT~Y. iLA,
R06ER r01T1tAS
itERK CIRCtNT'~'_st!
R?~1lf VERlFIE+L_,_
4t~2415
i
I FURTHER CERTIFY that I will register at my local address when the nBiatrati~ boob reopen. and eamply with aU
other regniremeMs ~ a legal resident o+f this State.
I FURTHEIt CERTIFY that I have ao intention to return to my former domie~e. and I intend to remain in
i ~ . ~ v ~ ~ County.
- 1(Sty1
Florida. permaaenti; .
J~~ g, CO{/NT`
o
c~
!G . c~' ~ ~a~)
C~UtiiY.F~~P
Sworn to and subscribed before me this ~ day of ~ 3 Z l.. u L BY ~ 2 ~ ~
• C-
p t o RT ~-z-. l..v c~ ~ ~t.._ X34 ~ ~
A.D.18~,..._-~
ROGER PO I TRAS. CLERK OF G 1 RCU I T COC~ZT
ST. LUGIE COUNTY, FLORiOA
BY: -
EPUTY LERK
_ e~Q
6tioMK ~J'~w Plt6E ~45