HomeMy WebLinkAbout0883 Declaration of Domicile and Citizenship
SU2415
TO THE CLERK OF THE CIRCUIT OOZJRT~
STS L UC i E COUNTY. FLORIDA:
This b m7 declaration d Domicile and Citinenship In the State d F7o:ida that I am tiling this dsy in aooordanae, and in
oonturmiq with Section 2?2.17. >i7o~ida Statutes.
I was former a legal resident d ~ O.~rn< < ~ ~ 1'1 y ~ ~ [ ~ and I
lQk~l 18tatal
resided at -l ~ 5_ ~r_~ AJ p.. ~ - However. I have ebaaged m~ domieaik to
(8tnat and Nosbarl
and am and have been a bona Ede resident d the State d Fbrida since daT d
Dc-lobe r .19~
~ . and I reside at 3 ~ 4 E a5-4- Pot ~ C ?'Cc,l Q~
(8t++~ ~ Aiombarl
r S-l~ ~ ~ ~ ~c~ ST . LUG 1 E CamtT. Fbeida.
~Clbl
and this statement is to be taken as my declaration d eiti~enship. aetaal kgai residence and domicils in tbs State d Florida.
If FOR THE PURPOSE OF ENROLLING- IF FOR HOMESTEAD PURPOSES,
CHILDREN IK SCHOOI, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
~nyr~
~r ? ~•~-~_~t mats !9:0 CCU '7 ?'r. 2 ~ = I
-
t tlEl~ RNf. Ft~tOR"•t a
M; c a ~ 1 (<e r rnc~h si. iucit ccu~~ ~ ~
ROGER Ptil ~ RA5
CLER!(CIFC'~'' C~~ r
L2~r,e~ CT~rmo.rl
_ Kt~rn', f'!f
502415
I FURTHER CERTIFY that I wdl reg>:ter at mT !Deal address when the registration boob reopen. and oompiT with aD
other requirements d s legal resident d this State.
I FURTFIER "CERTIE'Y ~thst I have no intention to return to my farmer aamide. sad I iatead to remaia is
_ _ u r_ ~ c Cooat~
_
Florida. permanenci, - .
- ~ ,7 -
swore to and.abseiibed before me this ~ ds~ d '-pC`t~ ~
[y
f~_~ .,r, c^~,~ ~ n ;
ROGER POI TRAM„ CLERK OF C IRGUI T CO~tT
ST. ! E COUNTY, FL.OR t A
BY: ~ ~ . -
C
. E TY LERK .
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