HomeMy WebLinkAbout0053 Declaration of Domicile and Citizenship 'fi'
494929
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E CpU~y, ~,p~A:
_ ~ .
This is my declaration of Domic~7s and Cttienship in the State of Florida that I am fitina this day in aooordance. and in
conformity with Sedioa 222.17. Florida Stat/~utea.
I was formed a legal resident of f> ~~L L N ~-~O ~ T ~ T= ~z and I
ICYtyI 18eate)
resided at ...f.~! ~ ~ ~JF T - However. I have changed my domieDe to
IBtrNe asd Namur)
and am and have been a bona fide resident of the State of Florida since 1 ~7 ~
~.~t~''~ -19 ~j~J . and I reside at fly" ~ ~ ~A?>~iLJf>~) t) % ~tS'
tStrssR asd NamMtl
v,- f _ ST. LUC I E County, Florida.
(City) ~
and this statement is to be taken u my declaration of citizenship. actual kgai residence and domico7e in the State a[ Florida. j
i
IF FOR THE PURPOSE OP ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOt.s PLEASE STATE PLEASE CAECKS
THEIR -NAMESS
_ ,r
I FURTHER CERTIFY that I wdl register st my local address when the registration books reopen. and comply with aU
other regainments ~ a kgal resident of this State.
' I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
_ U C 1 E County.
r _ (City)
Florida, permanenci; .
1980 aUG -4 AM ~ 57
FIlEO kNQ F.ECORDED
5 R~ER
POITRASA~
CLERK CIRCUIT COUR1 D
RECORD YFRIFtEO T _
.....r..
. ~ 494929
. - - ~ S 1,Q~ ar? 1. • o Qs rEa~ el
. ~T ` tAdd~w)
~ ~ • . ~ sntibarneribed before me this ~ day of j~>,-- ~ +~G • ~
,y a
- A.D. i
.
ROGER POIIRAS. GLERK OF G IRCUI T COtdRT
ST. LUG I E COUNTY, FLOR 1 O - -
• , w
~ BY: ' C ~
_ EPUTY LERK
- * - r
J
~ ~~n .T ;t 22
- 3