HomeMy WebLinkAbout2322 ~j
t~~c~~ration af D~rnicile and C~~iz~nship
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TO THE CL~;RK OF TIIE CIRCUIT COU1tT. j
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ST. LUC 1 E ~;pUN1~y~ Fl,pRIDA:
This is m~r decl~rAtton ot Doaniclle and Citizcnabip in tbe St~?te ot Rlodda lhat 1 sm Gliag thie day ia aeeordence. and in ,
coetormJ~y wiLh Srction ~2.17. Florida Statutes. ' ?
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1 was for~r~l
r a kgal rraidcnt ot -~~.Q . ~LS~ • . //~'J ~nd I
reaidcd at ~ 3 T~ 'v ~ U~ `~r, _ jiowevcr. I have eh~ngcd m~r domicil~ to
l&~e~t~dNmseerl • .
and am ~ad hav~ bccn a bon~ fidc residcnt ot the Slato ot Fbrida:inee d~y o[
' 19.1.=,~ ~ad I nside a~ ~/v~ Y~~ l~ l~~- -
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p~ J 1- ~~I Ei ST. lUC I Es~.,~aN~ea~
County. Florida.
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And lhis stalement js to be taken i?s m~r dccluratioa oi eitizcnship, actual kgal residenee and domieile in the Stuto ot Fbridn.
IF POP. TNE PURPOSE OF ENROLLING If POR HONESTEAD PURPOSES~
CHILDREN IN SCHOOI.I PLEASE STATE PLEASE CHECK: ~
THEIR NAHES:
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fll.EO A+~C ~fCUROf~
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aGC:. ~i i~0~'RAS
CLERKC'tCUttC01lRt
REC~J~f V=r;:~cp
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I FURT}1ER CERTIFY that 1 will rey,i~ter al my local address when the rcgistration bon{;s reopen. and comply with all
olher rcquirements ot a 1c6a1 resident of t!~is Statc.
I FURTJ1C;t CERTII'Y thst I have no intention to rcturn •to my (ormer domicilc. and I intcnd to remain in
' ~ ST . L UC 1 E . Counly.
i lCitr) . -
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~ Florida. permancnti;. _
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~ Sworn to
im~su~~~eril,r.d b~(oro me ihi~ dny ot ~
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~ RnG~R P_ I R/lS, CI_FRK OF C IRCUI T COUtT
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