HomeMy WebLinkAbout2795 ! •
Q~c~~ra$i~n of l~~micile an~1 Citix~nship
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TO TliE Cl,.~RK OF THE CIRCUIT COURT. ~
sr. ~ucre oourrr~r. ~r.onin~: ~ 315~
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Tbts b mr dccl~r~tlo~n ot Domklle and Ciltscnahip ia lAe Stato o~ ~'Iwida th~t l am tiUng this daU? iA accordanco. u~d in .
eoatornuty witb Scctioo E2Z.17. Florida Statutes. ~
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I was t m~rl a kga! ~sidcnE oi ~0 C~~ aQ ~ ~~~/~f e/,$ snd I . -
j~~~. C~TI . . iStatel
residcd at ~ 74 3 ~"""Y ~ S~~n a' ~ I'~ - liowever. I lu~vic ehanged my domicile to
IS~t ~ed tivmeer) ~l
and am ~?nd havc bcen i Dona Ctidc restdcnt ot the State of Fbrida sfnce ~ dar ot
Ll S f' ,.19~ ~ad 1 restde a~ ~c O/ ~ D/1') / I7 ~
~r ~J ~ (Stre~t aud omberl
r~ T j e r c e ST . LUG 1 E - Countr, Fbria.. •
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~nd lhis atatement is to be taken as t~r dectaratiot~ of citizenship. Actual kgal resideneo and domieile in the Slute oi Florida.
If POR TNE PURPOSE OF ENROLLtNG I~ ~OR HON£STEAD RURPOSES~
CHILDREN iN SCHOOL~ P~EASE StATE ~PLEASE CNECK: ~
tHE1R NAMESS
C.I,r~S flnP ~oc~~Se ~fe~so~ .
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IFURTHER CERTIFY tha~ 1 vmill regislcr al my loca) address when thc registration books reopen. and comply with ail ~
other requirements o( x k6ai residcnt of tt~u State. ,
E I FURTIIEZ CERTIF'Y ihat I have no intention to rctun~ to my formcr domicile. and 1 intend to remain in
F ' ~ ST . L U C i E . County.
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~ Florida. permanenti;.
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~ Sworn lo nn~l. ~}+sC ~L'ed t?etore me lhix __,L__ dny of r ~ / /e /~C ~ ~D l / '
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~ RnGF_R I 7RAS, CLERK nF C IRGUI T GOIXZT
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~ ST. Ll1C I~ COUNTY, FLOR 1,U
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