HomeMy WebLinkAbout2719 t~~c~ara~i~n c~f ~~m~c~6e ~n~ ~~~iz~nship
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TO THI~ CLERK OF THE CiRCUIT COURT. •
ST. LUC 1 E CpUrt'1`y. FLORIDA: . _
This b my declaratioo o[ Domicile and CitIzcnship in tM State ot Florida that I ua f~ir~ thia dq in aceordsnce. and Ia .
contormi~y with Sectiot? 222.1T, Florida Statutea. ~ '
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l was tormerlY kgal nsident ot ~Q~ : ~ I
t01ty1 lStat~)
resided at ~ r~ - However. I have chaaged my domicitc to •
~~StrNt and NusD~) . •
and am aad havc beea a bona fidc restdent ot the State oi Florida since d~Y ~ .
b 19~.. aad I nside at
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`~~iKr~.//~ , ~ ' . lSt~t ~ed Nwseer)
ST . UG 1 E Councy. Florias.
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and this statement is to bt taken as my decisntioa of citizenship. aMual kga) tesidenee and domicile in the Stato ot Floride.
IP iOR THE PURPOSE Of ENROLLING If ~OR HONESTEAO PURPOSES~
CHIL~REN IN SCHOOL~ PIEASE STATE ,PLEASE CHECK:
YHEIR NAHESS
fIlEO ANU HECURpEO
ST.IUCtE GOU!!T~ FLI~.
RO¢ER f01iRA5
CIE~,K ,i i~~fi COURT
~ Rif.~R:~ VERI~~F.p
~ M~r 13 2 36 PN'75
- 308874
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I FURTIIER CRRT[FY that 1 w+ll re~ister at my !c?cal address when the registntion books reopen, and compiy with all
oth.er requirements oi a legai resident ot this Stale.
~R IER C~ HTIFY hat I. i~ave no intcntion to return ta my former domicile, and 1 intend to rem:sin in-
$T . L U C 1 E . County.
. (City) _
Florida, permanenti;.
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