HomeMy WebLinkAbout2770 ~,~c~~~~~~~~~; t~a~rc~cil~ and Ci~i~~n~~~~p , ~
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li)'flil: S"1A'l~L• ANUCUltN7~Y 7'A\ A~St~.SSUIt, . ;
S7'. LUCTG !_CUUNI'Y, FLnKIDA:
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"ll~is is my dcclar:~tiun of Uon~icilc and Citiirnsl~ip in thc Statc of Florida that 1 am filing ihis day in i
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:,~•corclai?cc, a~~d in conformity with Srction ?22.17, 1~lorida Statutcs. ~
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1 was forni.~rly a Icg:~l residcnl of -----~-Q-4-- - ~s~,~~~
(c~ir)
~~•idc~l at ~~-~C-1Y---~~ G . Now~v~r, I havc changcd my domicile to :
- (Street and Nwnher) ~ }
,~nci am ar~d hcivc lx~cn a bona tidc r~sidrnt nf thc Staic of florida sina~ day of
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n 19 ~ aud i rrside at -/_--~~--~-~-5-1-~-~~~ S~
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~ v c St . Lucie . Count~~, rlorida,
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,:~~d tl~is statcmcnt is ta bc takcn :is my drelaration of citizcnship, a~~t~~at Icgal nsidcncc and domicite in thc Statc
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(Insrri hrre an} pertinrnt factc, such as salr of pruprr!y or b::sinesa, or relinquishmrnt ot em{?loyment at former
domicil~. remo~al of fanuh• to ne~v Jomicile, purchasr uf home, rlc.)
. . ~~or~s•r~,~n ExLrr~Tio~~~ : _
L!`:CERI":G CfiILD~:E:I I?. S~Ii00L. ~ .
1~ enteriiig childrer. in school, .
p' ease ? i.st their nar~;~s : -
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1 r'UiZTtIrK CI:RTIFY th~t I will rr;~ister at uiy local addmss when the re~;istration books rco~en, and .i
romply with all oth~r rcquiremcni~ af a lega! residcnt of this Statr.
I FURTIIER Cl:RTII=Y that 1 ha~~c no intcntion to rcturn to my fornzrr domicile, and I intcnd to rcmain in
S - ' _ST. LUGIE _ - Cour.ty, _
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E=lorida, • ,
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_~_~~.;s; . ~~'~-a-``___ A.D. 19-- '"'~`Ta113.c1~, ~ aQreS ;
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P.C~,E:t FC7':'Rt~~~,~~~CLER~: ~7KCUT?' CC~UR'r , F1_orid~
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(To Ix e utcd in du~•'Ka1r JfIII IIf1~IpJI !i1tA ~uth t'Ic~k Citcuit ('~.utl. an~ Jupti:+tc ~~i1h Tat Assccs~?rl
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