HomeMy WebLinkAbout2877~~clara~ion of k~on~icile ~~d Cifiz~nsiiip ~'
~ S~ 2298
TO THE CLERK OF THE CIRCUIT COURT.
ST. lUG i E ~p~Ty. FI,pRIDA;
This is m~ deeleratioa oi Domic7e and Gtitizenship in the State of Florida thst I am fling thts da~ in accordana. and in
conformity witb Scctioa 222.1?. F7orida Statutes. ~
I v- as formerl~ a legal resident of ,~'1 T ~lP~s,t ~E /t~ r ~L~ ~ G C and I
. lG~t~l IS
resided at ~ Z~~I S ~ P Y~~ hJ /~P ~.~, However. I bave cbanged my domici7e to
(Stieet aad N~ber) ~ J
and am and ha~ e been a bona fide resideat of tbe State of Florida aince ~ O v Z~- / 9 d 0 day d
.19~ , and I reside at 7/•~ ~ /"v' t-4.) •~.cZ-~/ A-~ d
p' ~/. , ST. LIJG 1 ES~~dN~~~
Count~, Florida.
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and this statement is to be taken as my deelaration of citizenship. actual )egal re~ideace and domicile ia tbe Stat~e of Florida.
" IF FOR THE PURPOSE OF' ENROLLING
GH 1 LDREN i N SGHOOL~ PLEASE ST/1TE
THEIR NANES:
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IP FOR HOMESTEAD PURPOSES~ ~
PLEASE CHECK: ~
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F 1LEC ~-~~ ~' CO+~D! 0
ST. Ll•(.IE COUH ~ Y. f t A.
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S~ 229~
I FURTI~R CERTI~'Y t6at I w~11 register at my loca] address v~hen the registration books reopen, aad oompl~ a-it6 aD
o:her requiremenb o! a legal resident of this State.
I FURTHER CERTIFY that I have no intentioa to return to m~ former domiciTe, and I intend to r+emain in
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f'lorida. permanenti;. ,~``
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Sworn to and subsrn'bed before me this `~ da~ of
~ ~~-~ tiD._ / 98/
ROGER POITRAS, CLERK OF CIRCUIT C0~'tT
ST. LUGIE COUNTY, FLORIOA •
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BY: c~~,~~
_ ~EPUTY r.LERK
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