HomeMy WebLinkAbout0283 Declaration of Domicile and Citizenship
4t~24~1
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E -COUNTY, FLORIDA:
This is my declaration d Domidls and Citisenship in the State d Florida flat I am Sling this dp in accordance. gad is
conformity with Section 222.17. Florida Stat~Les. _
u~ b Yl ~ std I
I was former a legal resident d .
lat~l lBtaW
resided at ~ ~ i ~ ~ ~ ~ y ~ ~ U ~ _ Aowever. I have changed my domie~7e to
(8traat gad N®~)
and am and have been a bona fide resident d the State d Fbrida ainoe /o ~ day d
~ .19 ~ ~ gad I reside at 7 8 G o? aC ~ ~P ~ 4 11 ~ ~ ? t~
l8tiwt and Nusarl
y ~i ~ P ~ _ ST . LUG 1 E Co+mty. F)aeida,
caul
and this statement is to be taken as ~ dee4ratiou d eitiaenship. actual legal residence and domicile is the State d Floeids.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOLr PLEASE STATE PLEASE CHECKS
~ THEtR N/AMESS
1980 APR -9 PR 12 32
FIL~EO~A~~p R: C a
sT~OGERC
OITR~SLA.
llElgi CMEUIT CANR
REMRS 1lERIF!Ed__._~__
- 42431 -
I FURTHER CERTIFY that I wID register at my local address when the registration boob reopen, sad comply with all
other requirements d a legal resident d this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile. sad I intend to nmsin in
~ _ JT ~ a.. U C I E , County,
racy)
Florida. permaaenti; . -
OT' IAdBf'a~l
sworn to and subscribed before me this 9 day of ~ ~ = (~~.u.c;¢, ~ .~a .
~ Q~
~„QJ1,a.L. . A.D.19~.-~
ROGER PO 1 TRAS, CLERK OF C 1 RGU 1 1' COtdRT
ST. LUGIE COUNTY, fLORtOA
EPUTY LERK
BtIOK d~~ PbGE ~.C7•, , .