HomeMy WebLinkAbout0311 Declaration of Domicil~ and Citizenship
-
~~~o~~~~~~~.
_ST„LUG 1 E OOUNTY. FIARIDA:
This ~ m~r declaratta~ ot Domtdle and Citi~asbip ia tlie Seats ot Fboeida that I un Btia~ thls dy. L~ sooocdanee. sad ia
oontoraucy .rtth seeNoo 222.17, I~'{orids st~wt~..
~.l.wLfw ~ `
I ass i rmar s 1eg~1 resideat ot Q~ - aAd I_ .
IC1t71 t
i'~ i~ a~~~ - RO'rMYOt~ T~1fe t~liD~ 11~ ~~O
. ron..~..a r~.~e.r? . ~
uid am snd have bsen a Sooa ~de resident oi tbs State oi Florjd+~ atnoe ~ ~0i
-19 aod I t~eside at 3 d~ ~ ~ S~ x.s-r'
' ' (8tiwt ~d Nwabwl
~J ~ t I w ~ 0 _ ST. Ll1C 1 E Councy~+'~v+~ss~
and tbis slatement fs to bs talteu u m~ detlaratioa oi dtisenshlp. adnal 1ega1 residente and doo~dk in tbe $tate ot Florida.
~f fOR THE PURPOSE OP ENROLLING IP POR HOMESTEAO PURPOSES~ _
CHiLOREN IN SCHOOI.~ PLEASE STATE PLEASE CHECKS ~
TNEIR NAMES: - ~
. -
a 1~NL l~fCORp~
. ~WCIE COUMTY f~ ~ "
?O~TR~3
AFCaRO Vf
if
EO C~T ` -
- - - - ~ Z~ ~ S? . -
~ €
, . .
- -
I FURTHER CERTIFY that I ~r~l register at my local addn~ when t6e registntion books reopen. u~d oomPly with ull
other requirements of a{egal cesident of this State.
n
' I THE EliTIFY thst I have ao iatention Lo return to my former domicile. and I intend to remain in
~ o_ _ ST . L u C 1 E , Coonty,
j ' (Cit7) .
I FMrida. Permanea~i; . .
~ •
I
~ c^~..:~3., .
- 4i t= :
~ ~'~:i,° ~ .
, ~3~~"~~.~~~~ +'':s;.T
. , ' '
~
Vv . ~ +I~ro ~
.1 a ~ -
, , _ . ~
~ ~ r•~ ~ , . .
~ ~ , V. G ;~J • _
~ 3~~; ~ ~~s~pG:~. Y ~s~':. ' ~ ~SCLeIiON!
yR ' - • ~ • t~ .t~(' '
. 't!, • ' 4i. ~ s ~ ~ ~ T :
: N :-t : . ~r (N~me).
t ~I
. ~
Z ' ~ ~ ~
~
~ - '~r 4' q ~1 lAddrewl
~ ' ~ • ~
,
~ Sworif4q ...~ty~sditied belore me thi~ duy ot
A.D.l9 7S
~ ROGER POI AS, CLERK OF C IRCUI T COURT
~ ST. LUGIE COUNTY, FL.ORtUA
~ . .
~
BYs
~ ~ E TY L RK
~ . _ ~ ~ gaox 243 ~ 3~.1 -
~
~ AGO Form 71 •22
~
~ -
~ . . ;
: ~
~ _ ~