HomeMy WebLinkAbout0246 Declaration of Domicile and Citi~enshi
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496904
TO THE CLERK OF THE CIIiCU1T COURT.
ST. LUC 1 E CpU~Y~ ~,0~~;
Thin is m7 declaration of Domic~7e and Citiunahip in the State of Florida that I am fling this daT is accordance, and in
eontormitl with Sattion 222.17, Florida Statutes.
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I was former a legal resident os - L ~ /Z~t-~- a~ I
~G' ~rZ / 1/ 1(Stt~l lstattl ~ .
resided at - Aowever, I have changed m7 domicile to
(BteMt gad Naaiber) .
and am and have been a bona fide resident of the State os Florida since ~ dad of
~ 19 ~y- and I reside at ~ ~
~ (sa..t gad Namb~r)
/~'Z~/f~ - ~c.~+~~..~ ST. lUG 1 E _Couat~, Florida.
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and this statement is to be taten as mT declaration of eitiunship, actual legal residence and domiale is the State of Florida.
'IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKt~ ~
THEIR~NAMEnSL
_ ~ ~ 2F-~ ~ 1960 llll~ 20 P~1 U2
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FILEC RNP Fr~CRUt..~
Sl.Ll1C1E W:I.rPY.fI A. ,
ROGER TOITRAS
CLERK ClitCIIIT SOG~.'
RECCAf1 ~'ERIFIE~~ _
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- 49b904
I'I I FURTHER CERTIFY that I w~71 register st mT local address when the registration boob tit~eopen. and oomph with aU
other regnireme~a of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to sets~ra to my former domic>7e. and I intend to remain in
U C I E - Count.
I - tCttr)
Florida. permanenti; .
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Sworn to and snbsan'bed before me this ~ 0 dad of
A.D.1 ~
ROGER POI TRAS. CLERK OF G I RGUt T COCdF2T •
ST. LUGIE COUNTY, FL-ORiDA '
BY: ~ -
EPUTY LERK '
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et~f PAGE • '
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A~C~ Farr, 7) ~