HomeMy WebLinkAbout2535Declaration of Domicile and Citizenship ~"
5~.0.3'~2
TO THE CI.ERR OF THE CIItCUIT COURT.
ST. lUG I E ppv~y, ~,O~p;
Thb b aqT declaration d Domieitis and Citisenship b- the State opt Fbrida that I am ~ thb daT is accordance. and is
eontormitj with Section 222.17. Floo<ida Statutes.
I was fo~ a legal resided d . ~~ -~-y • and I
_ IG41 18tatd
resided at _~~~ ~ -- - - However. I have changed m7 domids to
Itltre~t aad NeeDRI
and am and have been a bona Sde resident oohs State d Fbrida since ~~ dq d
IOJIt~~ .15~ and I reside at ~ ~C1 `t' ~ ~
~ (BtrMt aad Nombw)
ST. LUG I E - ~~.~a,
ldbl
and this stateme~ is to be taken as mT dee4ration d eitiunship. actual legal residence and domicile in the State d 1:7aida.
IF FOR THE PURPOSE OP ENROLLING IF iOR HOMESTEAD PURPOSES,
CNiIDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
~s~o oF~ l i ~ 12 os
SiQ372
I FUATAER CERTIFY that I will register at m7 local address when the registration books reopen. and oomP1T wit>, all
other requirements d a legal resided d this State.
I FUR1llElt CERTZF'Y that I have no intention to retorn to mT farmer domicile. and I intend to remain in
ter.--.
J T. L 1J G I E . Ci011~7.
IC~1
Florida. permaneatl; .
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~.:.:: ~ ~ MPS. ; OQ~O
V~~F ~Ci1:ISY •E~ ~ a.J ~~'
IA~d~ewl
Sworn to and snbeeribed before me thb ~~ diT d ~ +_ T S .
ROGER P01?RAS. CLERK OF CIRCUIT COC~iT
ST. LUGIE COUNTY, fLOR10A
., .
BY: ,~,~
EPUTY LERK
••,
.~
eoox~~ PaGE~ ~~ - , ._
. i
AGO Form 7122
r~icc ~-NC ~t:c o
sr.~ucif Cowlr°Y~~.
CLERK C RCUI COURT