HomeMy WebLinkAbout0559
Declaration of Domicile and Citiienship
sc~4s
TO THE CLERK OF THE CIRCUIT COURT.
ST. l UC 1 E COUNTY. FLORIDA:
~/
This is my declaration of Domic9e and Citisenahip in the State of Florida that I am 51ing this dq in accordance. and in
conformity with Section ?22.17. Florida Statutes.
I waa former s legal~r/es~id~ent of and I
resided at ~ y - However. I love changed my domia7e to
l8trsst aad Nasbw) ~ ~.
and am and have been a bona 5de resident of the State of Fbrida since f ~ 5 da~-1~
~;~V ~t~ , .19 0 ~ • and I reside at ~ 3 ~ ~~•L~) ~ ~G/S~* f.s~-Cc_~ `ii'i~iCr-p ~'
,~ 18tiwt.ad Hae~b.rl
ST . LUG 1 E qty, F'~da~
Idbl
and this statement is to bs taken as my declaration of citizenship. actual legal residence aad domicDe in the State of l`7arida.
" If FOR THE PURPOSE Of ENROLLING
CHILDREN IN SCHOOLS PLEASE STATE
THEIR NAMES:
~r
IF fOR HOMESTEAD PURPOSES,
PLEASE CHECK:
~ ~~ -3 AM ~ S4
Sr EUCIEII`CgqFf~q~TOYR. A-
R~R POlTRA -
CIERK CMIClfITCOURT
RECORD YERt~t[n_ . _ ~~ _
S()9145
I FURTHER CERTII~R that I w~71 register u my local address when the registration books reopen. and oomph with all
other regnirementr of a legal resident a[ this State.
I FURTHER CERTTIII~'ll that I have no inteatioa to return tom former domia7e. and I intend to remain in
U C 1 E _ County.
It7ity)
.'
~,
4~-
'~.
. ~~~ ~..
!„ .'
'~: 'i. ~
,~
•• ' 7-"
~-
~' : .~ ~ ....d_
~ ~,~
''
'CA'.. •
!` .
~t•~ ,i
- .,
m~~riAM M • SwM merS
r)/ j
•~fG~,,(,(.~(~~ 1~~, / jam;' ~ ,^.tifi~
t it~..l
~,. ~ IAdd/,eel I
Sworn to and snbseibed before ms this ~ day of ~ ~ ~ .ee / `LLB-t..~ •a CAL' ~/ " '{
., _
33~/s~
ROGER POI TRAS, CLERK OF C IRGUI T COC~2T -
ST. LUGIE COUNTY, fLOR10A -
BY:
EPUTY LERK
P
,~
'~ ~
~ _..
~~344 P,~E 559 - __i,i.„~ ,
Af n Fo-rr ?1 72
- - _k.,
Florida. permanensi; .