HomeMy WebLinkAbout0172 Declaration of Domicile and Citizenship
SU1989
TO THE CLERK OF TILE CIRCUIT COURT. .
ST. LUG 1 E ppU~y, ~Og~A;
Thin is m7 declaration of Domicile and Citissnship in the State of Florida that I am this daF is aooordanoe. and in
eoaformit~ with Section 222.17. Fbrida Statutes. ` / A /
I was forTner a legal resident o!t ~ S '1/ ~ ~ and I
Itxt71 IReaee)
raided at 200 y~-i•~ ~ t~ - Rowever. I have changed m~ domieale to
18trNt sed NamlK)
and am and have been a bona fide resident a~f the State oiFbrid: since / O /3 /~y da,T of
19__~ and beside at ~3 C~~,~ ~1t~ ,~~(b~
18t~t sad Nambal
Pi
w-t-rJ ~ ST. LUG I E Couati.
IQtjl
and this statement is to be taken u m7 declaration of titirenahip. actual legal reaidenoe and domicile is the State d l<'fa~rida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCNOOLr PLEASE STATE PLEASE CHECKS ~`I
THEIR NAMESS ~-1
• RO,Se,AvtK0.
19E0 OCT -3 P~~ ~ 16
1:lLEC RNC k~ce~~ca
S1,LUCIECOUHTY.TIA.
ROGER POlTR~15
CLERK CIRCUIT C~URt
• Q,~
Od_ _
501989
I FURTHER t~RTTIFY that I w~71 register at m~ local address when the registration boob reopen. sad oomp}T with sll
other regniremeats at a legal resident at this State.
I F'tIRTAERCERTIFY flat I love ao intention to return Lo m former domierle. and I intend to remain is
U C 1 E . Count.
- II:R,1
Florida. permanenu, .
rf1,1.'~!
. J` ~f -~'r
v- :n
.
_
Sworn to and anbsQibed before me'this dad of
D~~~ _A.D.lQ~. Rev. Leong L. ScoTr- .
ROGER POITRAS. CLERK OF GIRCUt T COtdF2T
I
ST. LUGIE COUNTY, FtQR10A
- BY:
. EPUTY IERK
•
.
34~ 172 .~~y -
!'rn F r~r 7l 22
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