HomeMy WebLinkAbout2201 Q~c~~ration ~fi ID~micil~ and C~ti~~n~hdp :
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TO THE CI,b;AK Ol~` Tlit2 CIRCUIT COUItT. '
ST. L l1C t E , _ Cot1N1'Y. FLORIDA: .
TMs ia my dcelareilion ot Doa~cilo aad Cltir.c~hip ia the Sti?to ot t'lorida thst l am CJias tl~is da,~r 1» accordanee. and in ,
coatormity with Sectioa ~2.1?. Florida Statutes. ; '
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I was tornncrt leg~l se~ideat ot d y~~ _ and 1
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~t S D/ 7 L(~ht l~i. J~ ' . - Howovcr. I havic eh~?~ed my domieito to
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and am i?nd lu~vc bcea a bona fidc r~sidcnl ot the State oi Florida stt?ce ~ v~~ ~ dar o!
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197 S- --~nd I nside ~?l 3 7 b'1.0.Ge~ ~
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_ 0~- S~- ' ST. LUG 1 E County. Fbrida.
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~nd ihts ataicment is to bo takca u r~r decLration of citizcnship, actu~?1 Iegal residencc aad domicilc in the State of Fbrids.
If FOR THE PURPOSE Of ENROILING IF ~OR HOHESTEAO PURPOSESi
CHiIOREN IH SCHOOL~ PLEIISE STATE • PIEASE CHECKS
THE IR NAM(ES.
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i I FURT}IER CFRTIF] that I will register at my local sddresa when thc registration bool:s rcopen, and comply with all
~ olhcr requircments of a Ic6a1 resident ot this Statc. ~
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~ I FURTIIT'~ERTjFY ~I ha e no in~ntion to return lo my farmcr domicile. and 1 intcnd to remain i~
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Florida. perman~nti;.
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ROGf-_R PO AS. GLE:RK OF C IRGUI T COURT
ST. LUG 1 C COUNTY, Ft Oft 1 t~A
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GPUTY LFItK
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