HomeMy WebLinkAbout0972 Declaration of Domicile and Citizenship
502465 -
TO T~ Q~RK OF'Pi~ CII;CUIT OOURT.
ST . LUG 1 E _ COUNTlt. FLORIDA;
This is ~ declaration d DomiciM and is tbs State d 1:7aida that I am ~t this dq is aaooedanae. aad is
oontormitj witb Section 222.1?. ~7orida Statutes.
1 was t rme a legal resident of R ~ ~r h 2 a c~ IJ
~ w
`~o c' lC and I
IC141 tsua?
resided d e l 1 - n t~u~C. • - - Howevet.I have ehang~d mP domisila to
18en~t d N.e,Mrl
and am and have boen a bona fide resided d the Sw~e d Florida since ~ d
~ c s~ _ - iS ~0 _ and I reside at 1 ~ ~ ~ ut5 ~ rcL tt, a u e
16eewt aad N~.rl
~,j• Pl` _r-L.~ _ ST. LUG 1 E Couat~r.Florida.
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and this statement is to be taken as mT deelaratioo d . aetnal legal reaidsnoe aad domi~e is tle 8tste d Fbrida.
IF POR THE PURPOSE Oi ENROLLING IF fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES2
!9°D Q!'T -8 ~ ~ 34 F
~irnh ~1 v ~aw~ N,'QhlArld
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- ~ S1.lUC CWNiY.T1 A-
ROG~R PQITRS.S
- CLERII CIRCUIT C^':~TD
- 502465
ti
I FURTII>;R CEl;1"IF'Y that I wDl register a mT local address when the registrstiao boob reopen. aad eompl,T with all
t
i other requirements d a legal resident d this State.
I FURTAER •CEATIFY that I have no intention to retorn to ~7 farmer domiale. and I iot~rad to remain in
"C 1 E CoantT.
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Florida. permanenu; .
1
:.art
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_ tAAie~l
sworn to and sobearibed before me this ~ dad d f' f . P i e r C ~ * F ~ O t , ' d o~
ROGER POIIRAS. CLERK OF CIRCUIT COt~tT -
ST. LUGIE COUNTY, fLOR1DA - - -
'
BY: = ~
~JEPUTY LERK
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Afn Form T] 22