HomeMy WebLinkAbout0375 ' n of Domicile and Citizenshi
Declaratio p
495134
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UC I E OOUNTY. FLORIDA:
This is m7 declaration of Domie'le sad Citisemhip in the State of Florida that I am 51ina this dad in aooordanoe. and in
conformity with Section ??2.1?. Florida Statutes.
I seas formed a kgal resident of S r~~1 d : s 9e _ A L. and I
lQft71 IStatel
resided at _ _ However. I have changed mT domics7e to
1~ sad Namber)
and am and have been a bona Ede resident of the State of Florida since ~ ~ ~7 of
Tl L C -19? and I wide at 1 y'1 ~ ~r: y : c ~ L +d
IStrMt sad NamMir)
L , ,g _ ST . LUG 1 E ~ti, Via,
ICtt71
and this statement is to be taken as mT declaration of citizenship. actual legal rebidenee and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES.
_ ~ k
i .9D.A~ ~
i
t
~ •
_ _
I FURTHER CERTIFY that I wi71 register at mT local address when the registration books reopen. and eompi~ with aU
other requirements of a legal resident of this State.
I FURTHER CERT'IF'Y that I have no intention to return to my former domicile, and I intend to remain in
- _ JT L UL 1 ~ County,
i _ ICit~] -
Florida, permanenri; .
t
~ 19~ A!
~ -5 PM 12~ 5S _
- S1~Lt
CIE tY.f`` A.
ROGER I~ITRAS
s CLERK CIRCUIT CGURi
_ 1
495134 ~ .
- y 7 4.. i~r,`r,.,.~ ~1 : Cdr, ~~v~,~
i ~ (Addewl
_ - '~r .d 1~' si~bed before me this ~dq of ~iS ~ '1'1....
- ~ A.D.l - ~
-ROGER POI AS, CLERK OF C IRCUi T COC~2T .
ST. LUG I E COUNTY, f tOR 1 A - - -
_ _ • •
~ E TY LERK
P~ 374
BnnK i
~ r,n r, _ 7~
4 ..r
, .
~