HomeMy WebLinkAbout1318Declaration of Domicile and Cifizensf~ip ~~
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TO THE CLERR OF THE C1RCtJIT COURT. ~
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ST. Ll1C 1 E opU~y. ~,p~w; . I
T6L is m~ declaration ot Domic~7e and Citizensbip in tbe State oi Florida tbat I am Sling this dq in a«ordanoe. and ia '~
oonformit~ w-it6 Sectioa 222.17. Florida Statut~s.
I was formerig a legal resident oi ~~ ~- ~~'~-~ ~ 1 e ,~ ~,z„~ aad I
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~ r~I '.~~,1 r. i. ~~ ~ r c.~ ~ . Aowever.I bave ebanged m,~ domieik to
resided st :
(St~ew aad Nambr)
and am and have been a bona fide nsident of t6e Stita oi Florida aince dq a[ ~
`~ - t9 ~ andIresideat ~~Ptfles Island 2~-" i.
18treet aad Numb~rl ~
. • , ~ . _ ST. LUGIE ~„n~.~;~ i
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and this statement is to be taken as m,~ deeluation of eitiunahip. adud legal residence and domia'le in t6e State o~ Florida.
' IF FOR THE PURPOSE-OP ENROLLING IF iOR NOMESTEAD PURPOSES~ ~.
CNILDREN IN SCHOOL~ PLEASE STATE PIEASE CHECK: `: ~
THEIR NAMES: ~
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Ri~G~R ('OIiRAS
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I FUgTHER CERTII~'Y tbat I wn~l register at m~ local sddress ~vhen the registration boob reopen, and aompl~ w~itb aD ,
otber nquiremenb ai a kgal resideM of this State. ~
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I FIIRT~A CEItTII~'Y that I have no ~ntention to retnra to m~ lormer domie~e. aad I intend to remain in '
' , 5'~,,, L U C i E , Co~unt~~
~ IGYh1 -
Florida. Permanenti;.
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ROGEFf p01 TRA$* C K OF C IRCUI T COC~tT
ST. LUGIE COUNTY, FLOR10 •
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- - BY: ~
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EPUTY I.LERK
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