HomeMy WebLinkAbout1144 Declaration of Domicile and Citizenship
49'7465
TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUG 1 E COUNTY. FLORIDA: -
This is my deeLra"tion of Domicils cad Citiseaship in the State of Florida flat I am filiag thb dy in seoordaace. and is
conformity with Section 222.17. Florida Statut~ss.
I was fo~ a legal resident of ~u ~ ~.,$!1} ~ n__ and I
lacy) 18tatel
r~eaided at o?ot a S ; ti c31
~ ~ • _ However. I have chanced my domidle to
(8tewt cad NamD~e)
cad am cad have been a bona fide resident of the State of Fbrida since ~ ~ day of
--19~~andIresideat~~ns fi4/YlR n)[J • e t5/'pe~P .4~rnl-,~
letrMt ~ NmoDKI
_ r~ ST. LUG I E Connt,.1E'lorids.
caul
and this statement is to be taken as my declaration ai eitir~enship. actual legal residence and domicils in the State et Flerida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: _
-
- r- ~ ,
- 49'7465
1980 AllG 26 P!~ 2~ 52
- FIIEI' AND P~CpltUfO
Sl.`UCIE CCUNtY.F``A.
ROGER POITRAS
_ CLERK CiRCU1T Cp13RT
I
I FiJRTIIFR CERTIFY that I ~ register st my local address when the registrsiion books reopen. and comply with all
other regniraments of a legal resident of this State. - _ _ _
I F[JRTIIER CERTIFY that I have no intention to return to my former domiede. and I intend to remain in
_ U G 1 E Connty,
_ lacy)
Florida, permanend; .
Z. f~
y
Y
Sworn to and snbseribed before me this ~ day of
R06ER POITRAS. CLERK OF CIRCUIT COC~2T -
ST, LUGIE COUNTY, FLORIDA
EPUTY LERK -
.
.
~COli~~ PAGEil~~ AGO Form 71.E
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