HomeMy WebLinkAbout1134 t~~c~~r~~oo~ ~fi ~~m~cit~ an~ C~~i~~nship
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TO T111~: CLERK OF Tl I~: C1RCU[T COUItT. 3~~3iC~,
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ST. lt1C 1 E ~ptltv~r. FI,O~tIDA:
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This is my dccla~ntion ot Domicile and Citlscnahip in the State o~ ~'lorida that I am C~ling this day in secord~nce. and ~n . ~
eontormity with Section 2~.~?. FloriJa Ste! te~. ~ '
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1 wu t~rmerl a Mgal resident of snd 1
Gty1 (Stat~1
a~ ~ ~ ~ + ~
~ ~ .t T _ ~i - Howevcr. I have ehanged my dort?icile to
(Stn~t and Nuw • : • .
~ad am end hsve bccn a bona fide resident ot lhe Stste of Florida since ~ d~y of
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19y~., ~nd 1 rostde at ~~C ~ . , t ~ ~ - ~
(3~e~t and NumE~r)
t 1~ ' ST. LUG I E " County. Ftorida.
~71
and this statement is to be taken as my declaration of eitizenship, actual legal residence and domiciie in the Stste of Ftorida.
IF F'OR THE PURPOSE OF ENROLLING iOR HOHESTEA~ PURPQSES~
C~i1LOREN IN SLHOOL~ PIEASE STATE PLEASE CHECK: .
t'HE IR NAMES: ~
1~
- FIIEa ~!iC NEC~RDED
ST. tUCiE CUUNTY F~A.
RC^ER FC;YRAS C
~ CLE°t C:r.~UfT COURT
RECOkn vE~~{~fp
~ . Mar 11.10 4s AM'?5 i
34'7'~92 =
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I FUItT1IEl: CF,ItTIFY that J wil! rc~istcr at my tacal address whcn thc re~i :trz[ion 13oo;;s reopci?, and compl~ wilh :.Il
othcr requ~rc~nenls o[ a Icti.e! resid~nt uf Lhis State.
1 FURTIIi;;{ CI•:It7'it'Y tie: L I fiavr rio it~trntion to rei~~rn to my former dornicile, ~nd 1 intend ta r~rnaerti in ~
` - $T ~UC i E Counl;/.
(Cityl .
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! I'luricia, prun:?u~•nti;.
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NOTARY PUBL IC: STATE OF:~~nR~~~D v.'
LARd6. MY COMMI SS ION EXf%J~~•;~?• ~
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