HomeMy WebLinkAbout2608 C3~C~a~a~ia~n of t~oi~~cc~e ~~zc~ C~tiz~~shE~ ~
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c~'I I f t: S'I A'!'L A N Lf C'UUN7'Y ~'AX ASSGS50It.
ST . t.UCI F. CUUNTY, f LUkIUA: ' 4
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Tf~iti is my drelaration at' Domicilc a„a c~c~~~„si~~n in thc Statc ot Hiorida th:~t 1 an~ fiti~~g this day in ' t
~,rcorclancc, and in coni'ormit~'wit1~ Section 222.17, Florida Statutcs.
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r~ yo~ _ and 1
1 v~•:~s famicrty a lc~;al ru.tident of ---~lri9~~iY~=4 (su~o)
rrsicird a1 ~_.-!r/-C~-..~1i!Bl~~-1~~-"'~---- . Howcvcr, 1 havc changed my domicilc to
- (Streel s~d Numt~et)~
ancl an~ and ha~~e been bana ra~ r~sident ot tl~c State al' Florida since d~Y
19_ ~ , and 1 nsidc at ~Qy` SP~x s'~'aTc 11'B•1o _
t!_C~~~~- + ~ (Strcet and Number) •
St . _Lucie County, I'lorid~,
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;,i~ct ti~is statement is to b.^ laken as my declaration af citizensl~ip, actual legal residence and domieilc in the State
oi l~lorida.
(IuaeN herc any p~•rlinrnt fa.ls, such ac sale uf proprrb• ot husivrss, c+r reiinyuishment ot employment at former
dor.~i,•ila, nm~~~al uf family to n,w Ju~~ici~c, purchase nf hom~,.=~J
~ . NOi•~..`'i~'EAD EXisTff'TIO•.'i : ~
E`]T~RT":G CHYLPRE?~ I;1 SCHOOL. ~1
If_ entering cl~ildren in school, L~ -
please l~st ~hci r narses: ~
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_ LUCIE CO~~
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1 FUtt~'HER C~ttTIT~Y that !~+~iU rerister ai ~n~~ local address whe~t the registration books rcopen, and
com{~ly with .ill qther requiremcnts of a le~a! resi~~nt oi' this State.
1 T'URTHER Ci:RTIFI' th. t 1 ha~~c no intentien to rcturn to my fornicr domicilc, and I intcnd ta rcmain in
- ~ - ST. LUCI~
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S~votn taand f ri~scr~bcd bcfom ~tt: thia daY
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I;O~E~' iGITRAS~ CLERK ~IRC'JIT C~i)P.T ~ i_ , Fl~rida
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(Tu I,r eYecutrd in Ju~ l~c•rlr auJ uri ~~n~l Id.d ~cithvilRrk fi:: uil CouN. ''~PIM ale wil~~ Tas Aswcwr)
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