HomeMy WebLinkAbout0122 Declaration of Domicile and Citizenship
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COUNTY, FLORIDA:
This is my declaration of Domicik and Citizenship in the State of Florida that I am 51ing this day in accordance. and in
conformity with Section 222.1?, Florida Statutes.
I was fo_rmr a legal resident Of ,~...j, ~ ~ ~ ' Y ~ - _ and I
lG~t~) IStat+a)
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resided at - f ' ' ~ ; ~ l ' f " L ~ ~ - However. I Gave changed my domitile to
IStrNt and Nnm~rl ,
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and am and have been a bona Ede resident of the State of Florida ainee ~ ~ - ~ ~ ~ 1 l! - ~ day of
- ~ f ~ / _ " 19.,,,,.x. and I reside at ~ ~/mar ~i L~~L- -
IStra+aR and Nambar)
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~ ` ~ ~ ST . LUG I E County. Florida.
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and this statement is tabs taken as my decLntion of dtizenship, actual legal residence and domiale in the State of Florida.
IF fOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES!
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS •
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I F{JRTHF.R CERTIFY that I will register at my local address when the registrstian books reopen. ant comply with all
other regniremeats of a legal resident of this State.
I FURTI~R CERTIFY that I have no iateation to _return to my former domic~7e. and I intent to remain in
4-- 5~L U C 1 E County.
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Florida. permanenti; .
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1 i (Addt~ad,. .
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Sworn to and snbsesibed before me this ~ day Of ` r
" + l / rte..` ~ ~ • ar ~
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~ ROGER POITRAS, CLERK OF G IRGUI T COCd12T
ST. LUGIE GOUNTY, fLORtOA -
i EPUTY LERK
€g , BOCK V itJ PaCr if~I rJ
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