HomeMy WebLinkAbout1287 Declaration of Domicile and Citizenship
• 49"7544
TO THE CLERK OF THE CIRCUIT COURT.
ST. lUG 1 E COUNTY. ~,p~A; •
Thb b rep dscbrat~ion of DomieDa and Citbenship is the. Stag ai Flaida that I am 8tins thb dq in aooordanos. sod io
• cooformlt~ with Seetioa 2?3.17. I~'laida Statutes.
I was i~r s bgal resident oI • . and I -
resided at f
~ lr C.+L~ /1[/~ i 171 • ~ - 18tat~ i
However. I have ehaoged domidle to
and am snd have been a bona 5ds resident o[ tDe State of Florida sins ~ 7 dU of •
_ ~ _ / V i
19
~ and I reside at 3 S ~
18vwt.aaNsa~
~[.viL~. ST. LUC I E
IOlyl
and this statement b to bs taken u mT deelsration d eitbenahip. actual legal :+esidenae and domie3is b the State at 3`7orida.
• IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSESi
CHILDREN IN SCHOOLr PLEASE STATE PLEASE CHECKS
THEIR NANESS
' r
1950 AUG 27 PN 12: 22
fIlEO ahC F;COROFttO
St~~EIER
Po
TRaS A.
aERlc clllcculr covRT
RECOttD L'fRIFKD_~_~_
. 49'7544
4
I F[JRTHER CFRTII~R that I w~11 register at mT local address when the registration boobs >reopea. aad eompb with sD
other requirements of a legal resident of this State. ~
I FUR1'IIER CERTIFY that I have no intention to return tom former domie~7e, and I intend to remain in
_ U C 1 E ~ Coaat~.
_ 1(St~l
Florida. permanents; . -
-
• #
1
t
A~
IAain~
- Sworn to and mbeeribed before ms this ~ daj of
A.D.1~ .
• = K F C IRCUI T COtd2T - •
t_~4 ~1, ~ • s~~ FtOR 1 OA J
,
t ''s' ~ EPUTY LERK ~ . w. •
- i
- -s't,j,,~, 8001f ~ Pd~,i1Gr ~ ~ ~ j
- ~
AGO Fcrm 71.72
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