HomeMy WebLinkAbout1155 Deciaration of Domicile and Citizenship
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ST. LUC 1 E apv~y. ~,p~A;
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. 17ds b aqr dscLntioa at Doenkils ~ad Citiseoship ia tb~ 8tat~ ot Floeida that I aa~ 81in~ this d+qr is ~eoordana. aad ln
ooota~aiqr Nith 3~etioa l22.17. b'focids 8tatutM. . .
I was t~ ~ k6a1 resideat o~ .j, ~~'t/S'SU'e ~ , aad i
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r~sidsd at ~d ~/'/~i~"~ - Ho~wwer. I baw etiat~ed aqr doenidM to
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aad am aed b~w be~a a boaa fyde raideat ottM Stat~ otl~7oeid~ sinoe , ~ON'~i4f/ da,~r o~
, i~~, ~a i ~a..c ~po2 /.~~'~~t~s/ GbP/~~
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fi.~'7` ST ~vci~" ; J~t~' , sT. L.uG ~ e
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and this statement ts to be takea as ~r deelsrstion o[ dt~ensl3p. setwt k`s! t~idenos and douiidie In t1w State at FIQ~3ds.
If iOR TME PURPOSE OP ENRO~IINC If i0R HONESTEAO PURPOSES~
~ CHILOREN IN SCHOOL~ P~EASE STATE rLEASE CHECK2 ~
THEIR NAME3: •
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. FtIED R` ~~NOED ~
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~:RAS ~A.
CI~R~ C'~GUtT COURT
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: ~y 3 10 03 AM'75
32015'7 ~
I F[JR'PHER CE~iTIFY that I wrill register at my bca! addnss whea t6e registntan books reopea. ~nd eomply writh•all
other requiremenb o[ a legat risident oi this State.
I FUBTHE,'i CERZ'IFY that I_have rw inteatioa to retur~? to m former domici7e. and I intend to remaia in
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Fbrida. Permaneati; .
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aad~tb~cribed be[ore me this ~ day oi r i
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ROGER P01 TRAS. CLERK OF C IRGUI T COt~2T
ST. LUGIE COUNTY, fl.ORiDA
8Ys
PUTY LERK '
. ~ ~o~ 245 P~~150~
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