HomeMy WebLinkAbout0199 yr
Lion of Domicile and Citizenshi f~
Declara p
496881
TO TIi~ CLERK OF TAE CIItCUIT COURT.
ST . UG 1 E COU~y, ~,O~A;
This is mI declaration os Domicl7e and (Stizeaship in the State of Florida that I am fling this dad in aooordanoe. and in
ooniormit~ with Section 222.1T. Florida Sta//t~~~te~~s. , ` .
I was lormer a kgai resident os 1~7T`1~. j'1~Z , ,1VQ bra 5 ~ c3 and I ±
ICtt~! 191atd
resided u 1 eZ ~ D 1 However. I have changed m~ domiG7e to
(8tr.~t I~lomeid
and am andbave Deen a bona Sde resident of the State of Florida ainoe `S ~ ~7 ~
r_~ n~ 19- a
~ . and I reside at ~ 3 ~ ~ ~ idAF~~~rt k~
(8trnit gad Namba)
~o.r ~ ~ i n+ L t~~ i~ _ ST . LUG I E Counh, I~9orida.
lave
and this statement is to be taken as m7 declaration d eitisenship. actual legal reaidenoe and domio7e in the State at Florida.
IF FOR THE PURPOSE O~ ENROLLING li FOR HOMESTEAD PURPOSES, '
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMESL
- ~ i Cho lad
i9SQ AlfG 20 P!R ~ 19
Rno~la Lu_-~~ Filc ~Nt a~caR~Fo
' ~r ST. COIplTY.FLA. ~
( q. ~RII IRC~T T
r ih-l-nn he L~~r S
• RECORD ~'ER1i1EII,~.~~--
496881 `
{ I FUBTHER CERTIFY that I wlII register at m~ local address when the registration books reopen.- and oomph with aII
other requirements of a legal resident a[ this State.
I
C I FURTAER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
U C ~ E Count.
~ - a~ r -
Florida. permanenci; .
_
V:•
- . 1 ~ -
~l
!i : v ~ 3 (Naas
SwOTn t0 iDd ill `~O!! me this ~ dad o~ ~
3~~~ Z
a . A.D. i o
ROGER P01 TRAS, CLERK OF CIRCUIT C0~2T
ST. LUCIE COUNTY, FLORIDA - -
- - BY: ~ C~~
EPUTY LERK ~
. -
8~~~~ PAGE ~ -
. -~i'"
ACn Form 71-22 ~y
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