HomeMy WebLinkAbout0387 •
.r.-
1
Declaration of Domicile and Citizenship
482495
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E optn~y. FLORIDA: ~ "
E
This is m~ declaration of Domicile and Citizenship in the State o[ Ffoeida that I am Song this day in aooordanoe. and in
conformity with Section 222.1?. k7orida Statutes.
I was farmed a legal resident of ~~l(i m h ..A ~ a~ I .
IQW) " 18t~te)
resided at 1~ GAY/' P However. I have ebanged aU domicde to
i8trwt asd Nombc) ~
and am and have been a bona fide resident of the State of Florida since ~~~~r ~ day of -
,,S'A 7 ff .19
8a , sad I reside st ,.~0 R ~ GU- ,r9i ~Pd .So /3/V d
lBteMt atdNamb~rl
P~~Pr ~S~ L ve ~ F ~ ST. LUG 1 E ~ ~ county.
laa)
and this statement is to be taken as aq declaration of citizenship. actual legal residence sad domirSe in the state of Florida.
IF FOR THE PURP05E OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: r--'{ "
THEIR NAMES: ~.~1
/~f/;:SSA ~'~~t~ol~
r
19~ APR f 0. AI~t ~ 42
Eo cTTatof`o
~L~~TRASA'
CLERK
~lMM VERIPiap
~~~3~'l___~__~
" 482495
I FURTHER CERTIFY that I wdl register at my local address when the registration books reopen, and comply with all
other requirements ~ a legal resident of this State. ~
i
I FURTHER CERTIFY that I bave no intention to t+eturn tom former domiei7e. and I intend to remain in
U C 1 E ,County
(Cdj)
Fbrida. permanenu; .
g, COU/yT ~
fP~~;~s J ,
!G ~.~o Mt ~~s~' ~O!
. ~f ~~UNTY.'~'~P IName)
leaa~...)
sworn to and snbsen'bed before me this day of ~
~ ` S~ L UP,1 /A
A.D.19
-
ROGER PO~TRAS, -CLERK OF CIRCUIT COt~FtT
ST. LUCIE COUNTY, FLORt~A ~ - i
- „
. EPUTY LERK
- BISOK PAGE