HomeMy WebLinkAbout0434 Declaration of Domicile and Citizenship ~
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49'7012
TO THl$ CLERK OF TAE CIItCUIT COURT.
ST. LUG 1 E oovlaTY, FLORIDw:
This is ml decLratioa of Domicile and Citisenship is the State od Florida that I am Elias this daT is aooordance. sad in
oonfarmit~ with Section 222.17. Florida Statutes.
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I.vas former a legal resident od ~1'LCASII~i G!L ~ a~Ls~ and I
~ IC~iyl 1l3tdd
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resided at ~ ~ ~4 SS V ~ c~'e - However. I have changed m~ domicDs to
IStrMt gad Nnmbr) ~ ~ ~ 4
and am sad have been a bona fide resident oaf the State of Florida siaoe I ~7 ~
19 ° and I reside at a a O dL ~3 ~ ~ r e a-~
~ 18trmt aed Nombr)
~o r-~ v'~ e ~ c P _ ST. LUG I E ~„nti,
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and this s4tement is to be taken as mj declaration o[ eitiumhip. actual legal residence and domieDe is the State of Florida. . #
IF FOR THE PURPOSE OF ENROIt..ING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
190 ~U~ 22 A!~ ~ 4 6
FILEO ANC RFCOROEO
ST.IUCIE CpUNTY.FIA. ~ ~
RO(3l~R POITRAS ,
CLERK CIRCUIT COUR~ _
RECaa(11'F~1F1E0~ -
49'7012
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I FURTHER CERTIFY that I wt~ register at m~ lord address when the registration books reopen, and aompy with aD ;
other requirements a[ a legal resident cI this State.
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I FURTHER -CERT'TI`'Y that I have no intention to return tom former domic9e. and I intend to remain in
_ L. U 6 1 E _ Count.
I _ ICit~I -
I Florida. permaaeasi; . ,
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- Sworn to aad'.su • . w ~ ore me this diY of
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O
~ f A.D.19~ ~
R GER A C ERK F C IRCUt T COC~2T
ST. LUG I E COUNTY, f LOR OA - - -
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BY: ~
EPUTY LERK
800
~JV~ PAGE ~.r.~
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