HomeMy WebLinkAbout1500 Declaration of Domici~e ana c~t~zensn~p ~ . ~
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To~ ci.enic oF~ cuscurrcov~r. . ~ `~16~6
ST. ~IUC 1 E apUt~rrr. ~,ottmA: -
Tbis b mr decl.rauon ot nomiet~s ana (~cisea~Ltp ta ehe stace ot I~to~wa cbat I aa~ ~tna ct?ts aq? ia ac~oed.noe. a,+d tn
coatcrmity with Seetioa 2?8.17. Florida $tatutei .
I w~as former a k~aal resideat ot ~ I
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ms~ u 6 0 7 y~~ - How~ver. I have e1~an~ed m~r domie~'le to
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aad am aad have baen a bons C~de restdeat ot ths StatA ot Fforida siaee
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" -19 ae~d I reside at ~ l-
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and tWs statement is to bs taken u aa~r daelustion ot eiti~enship. actnal 1e3a1 reaideeue aad danie~7e ia ths Stste ot Florida.
If fOR THE PURPOSE Of ENROLLIN6 IF fOR iIOMESTEAD PURPOSES~
CHILOREN IN SCNOOL~ PLEASE STATE PLEASE CHEEKi ~
THEIR NAMESS
fILEO awp RECOROEO t~
SL LUCIE COUN71~ f<~, r.
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_ • CIEP,K C;i CUlT COURT
RECOR~ vFprFiE~
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I FUR1'HER CERTIFY that I w~l register at my locsl address ~rhen the registration books reopen. and compl~ w?ith all
other requirements of a legal resident of this State. ,
I Z CERTIFY that I have no int~ntion to return to m former doaue~7e. and I intend Lo remain in .
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: Sworn t~f'iiid~subscrit,cd belore me this da ot
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~ ROGER PO~IRAS, CLERK OF CIRCUIT GOURT ~ ~
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~ ~ST. LUCIE COUNTY, fLOR10A _
~ BYs
~ . UTY LERK O R
Boox243 ~?~1~
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~ AGO Form 71-22
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