HomeMy WebLinkAbout0157 Q~C~~ra~ia~n ~fi ~~mici6~ and C~t~~~~~h~p
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` 313321
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TO TlIE CLE;RK OA' TtiE CIRCUIT COU1iT.
ST. lUC 1 e (7pUNTy. FT.pRIDA:
Thts ta my dcct~~ation oi nomicila and Citizcn~hip in the Slato ot Florlda t}uil I am t~7ing tht~ day !n aceord~nco. and in _
conformity with Srctiot~ 2~.17. Flo~ida Slatutcs. ~
I was tormcrl A lcg~l restdcnt oi ~.~L1--~~-~ , ' and l
1C~1 . ate)
residcd at ~ ~ = . Iiowovcr. I hevc changed my domicila to
(&trret and NnaeDer) '
and am and hevc bccn a bQn~ fidc resident of the State of Florida ait~ce day of
~ ~ .19,~L, ~nd I reside at ~ - -
~ ~ . treet ~nd Nnmber)
, ~~~o~,~, ~ ST . LUC I E County. Florida,
' «s~~) - . ;
and this statement is tq1be taken ~s my decinration oi citizenship, actual legal residence snd domieile in the State of Ftoridn.
i
IF FOR THE PURPOSE Of
ENROItiNG I~ FOR HOHESYEAd PURPOSES~ ~
CHILbREN tM SCHOO~~ PlEASE STATE PLEASE CNECK: ~
YHEIR NAHES: , ;
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F,
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I FURTIICR CFRTIFY that I will regi~tcr at my local address wl~en the registration books rcopen. and comply with al)
othcr requiremenls ot a lc~al residcr~t of tl~is State. ~
e
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I FURTI~E: ERTIFY ihat I have no intention to return to my formcr domicilc. and I intcnd to remain in
~„~'r
~'p.~.-~~
- ~ $T . LUC 1 E .Cauuty.
(Crtr) .
Florida, permanenti; . '
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FILEO AhU RECORDEO ~
St.lUC1E COISNTY FLA.
ROGER P~iTR~S ~•t'
~ CLERK Ci*"cCUlt COURT ~
~ PECOP.D YE°.'FIED_.......~.~ _ ~
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Swo~•n to~anJ ~ul?rcrii,ed bciu~ ~ m~ this ~~J dny ot ~
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ROG PQ I TR/15. CLFRK OF C I RCU I T COUf2T
ST. LUC ' COUNTY, F L.OR 1.OA -
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