HomeMy WebLinkAbout0303 Declaration of Domicile and Citizenship ~I ~
sO~Or72
TO T8E CLERK OF THE CIItCUIT COURT.
ST. LUC 1 E COU~y, ~,O~pA;
This is ms declaration d Daoiea7e and QititenahiP is the State d Florida that I am ~ this dos io aooordaace. and is
oootarmits with Section 222.17.1<7o:ida StatuyteQs.~ j
I was fo~ a 1ega1 resident od / ~ ~ I
~J ~1 cac~? t
resided at ~ l `D~~ - 8oweees. I haw chanced m,T domie~to
18ttMt asd IravbR?
and am and have bees a bona fide resided dtbe State dFlorida aiaoe ~ dos d ,
19.~, sad beside at / ~ (9-Q x'f ~ ~~'~t-u- ~b~C "a°~-~
~dt-e-~- ST. LUG i E~~N~
IA41 Counts. h7aids.
and this statement is b be ta><en as mr declaration d dtiaceaahil?. actual bgal residence sad domicile is the State d Florida.
- IF FOR THE PURPOSE OF ENROLt.ING IF lrOR HOMESTEAD PURPOSES
CMit.OREN IN SCHOOL., PLEASE STATE PLEASE CHECKS
THEIR NANESS
19c0 OCt -6 i I ~ 32
` - flLEQ ARC CUr'tN 0
_ - SL! ltC1E COUM?Y.FI A.
ROGER POITRAS
CLERK CIRCUIT CCUd~
_ k; C: Fn ~'I RIFT
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I FURTHER CERTIFY that I w~71 register at ms local address when the registration boob reopen. sad ~ with all
other req>ouremeata d a legal resident d this State.
I F[JRTAEACERTIFY that I have no intention to return tom former domia'le, sad I intend to remain in ;
_ _ U C 1 E _ ~ Couniy.
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Florida. permanenci; .
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8irorl+ Atlbeeiibsd before me this dos d
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A ERK F C iRCUI T COt~2T ~ ~ ~S ,
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ST. LUGIE COUNTY, FL 10A - -
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. EPUTY t.ERK ~ -
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gpp~ PAtif t7Vc)
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A~0 Form T1 22