HomeMy WebLinkAbout1145 Declaration of Domicile and Citiienship y
49'466
TO THE CLERK OF THE CIItCiJl1' COURT.
ST . L UC i E COUNTY. FLORIDA:
This is m~ declaration oaf Domk~e and Citizenship in the State of Fbrida that I am filioa this dq in aooomdanoe. and is
conformity with Seetioa 222.17. Florida Statute:.
I was former] a legal resident of ~ - ~ces~ aad I
It~t7) l9tatal
resided at oZ O ,S ~~-.~ttiter~- Aowaver. I have changed m~ domiea7e to
(Stmt and Nambarl
and am and have been a bona Sde resident of the State of Florida :face /s ~7 ~
~ -19 S ~ - and I reside at s /..$'~/j. -
(s3tnat asd Namb~tl
_ ST . L UC i E ~,mh,, Via,
and this statement is to be taken as m~ declaration of citizenship. actual legal nsidenoe and domiet7e is the State of Florida.
IF FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMES: ~
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49'466
- 19~ ~l~G 26 P~+ 2~ 53
ti fILEO AtiQ ~rGUk0E0
S ROGER
POITRASA
- CLERK CIitCU11 COURT,~ry~•
I FURTHER CERTIFY that I wt71 register at mT loin address when the registration .boobs reopen. and oomplT with ali
other requirements of a legal reaide~ of this State.
I FURTI:IER CE~'Y~hat I no intention to rettTrn to mT former domiet7e. and I intend to remain in
.
i 3. . J T. ~ V b 1 C C011nt~.
` I(~tr1
Florida. permanenu; .
, , jJ,~,~. is ~`J.
`t.• _
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.
Sworn to and subsen'bed before me this ~ daT of S O ~ - /S,T ,
A.D. l$~.~:.
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ROGER POITRAS: CLERK OF CIRCUIT COtdF2T
ST. LUGIE COUNTY, FLOR10
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- 8Y: C .a
EPUTY LERK
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