HomeMy WebLinkAbout0253 claration of Domicile and Citizenshi
De p
495046
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FIARIDA:
T'his is my deeLration of Domie~e and Citizenship in the State at Florida that I am Sling this day in aoooz+danoe. andm
conformity with Section 222.17. Florida Statutes,
1 was former a legal resident of T'O ~ n/ O!a NLeW O A S" E _ NEW yO1Q K .and I
ICttyl . 18ute1
resided at T~ l p ~ S'f'. M't: ! t t S ~ O J 0 SN'9 _ However. I have changed my domicile to
t8trwt gad Nas~br) .
and am and have been a bona fide resident of the Sate o[ Florida since T ~7V 'T Y - F/ ~ H TH day of
U N E -19 g0 , and I reside at a A r A N ~jf `rA E S 1 3 ~ R N D ~'F 8- /
. tStaMt red Homb~r)
g EIt1 B EA c N _ ST . LUG 1 E County, b'lorida.
(Cityl
and this sutement is to be taken as my declaration of citizenship. actual legal residence and domia'le in the State of Florida.
_ i
IF fOR THE PURPOSE Oi ENROLLING If FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS ~-...J
_
i
i - ~ . 2
I FURTHER CERTIFY that I wdl register st my local address when the registration boob reopen. and aompiy with all
other regniremenu of a legal resident oaf this Sute.
I I FURTHER CERTIFY that I have no intention to return to my former
d~~d"
e. and I intend to remain in
J7 . ~ u c ~ r County.
ICrtr1
Florida. permanemi; .
1980 All~i -5 AM~ 55
FILED RkC FECOitpt 0
5 ROGER
POITRAS A~
~ ~ ClEldt CIRCUR CGl?R3~
RECGP.D VERIfIEO___~
~ _
~ 495046
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- s r, RT. 1 A ~ A N i= Tf~-~s 1 S c.flND 8-)
Sw' ' En ` 'before me this ~ day of ~ENS~7U ~14GH. Fi-A• 33'il-S 7
A.D.1
R GER AS CLERK OF C1RCUt T COt~2T
t
~ ST. LUGI E COUNTY, FtOk a ~ - -
~
~ EPUTY L.ERK
MJ
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nK c)e)LI P1GE (~~~r ~ .y
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