HomeMy WebLinkAbout0411 L~~;C~ara~o¢~r~ ~fi ~e~m~c~~~ ar~~ Ci~ix~~~h~~
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TO TII~: CLF:RK O~ TNE CIRCUIT COURT.
ST. LUC t E ~pv~y~ FI,ORIDA:
Thes Is my declsration ot Don~icile ind Citizcr?~hip in the Stale ot F'lorida thet I am fiting this day i~ aeeordance. and in
con[ormity nrith Section 2'r''1.17. Florids Statutes. ' ~
1 wsa tormc~ a kg~l residc~t of _ and I
, (C~lrl lStat~)
resided at ,~~owever. I have changed mr domicile to
(Stn~t ~u~d Numbsr) .
a~d am and have bcea a bona ti ~ r s~
e t oi thc State ot Florida ainca day oi
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- L 19 and I reside at ~ z n ~V.
~ (Street aed Number)
~ ~~~jp~ ST.. LUG 1 E County. Florida,
(Citr)
and this statement is to be takcn u my declaration oi citizcnship. actual legal reside~cc and domicitc in the Statc ot Florida.
IF FOR THE PURPOSE OF EMROLLING IF FOR HONESTEAO PURPOSES~
CHILOREN IN SCNOOL~ PLE/1SE STA7E PLEASE CHECK: ~
, THEIR NAM S2 , ^
? 6~ f~~~~~.
FIlEO A!ih RECOROEO
ST.ll1C1E COU~TY FLA.
• ROGEh ~0?TRAS ~ •
CtEQ~ 1t1 COURT ~ ~
oEr,aRp ~iE4:>'-^------
~ I~~Y 5 9 3s AM'75
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I FU}tTIIF~R CEI:TIF~' that i will ir~ister a! my l~ical address w•hen the re~,~stration books reop^n, and comp!} with ~ll
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, o! hc~r rcquircenents ut a I~~;al res:dent of itus State.
I FURTIIi:;t L•:RTIF '~that I have Ro ~nt[-nti~?n lo returu to my former doinrcile, and 1 intend to rcmain in
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