HomeMy WebLinkAbout2675 Declaration of Domicile and Citizenship /
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TOTHE CI.F.RK OFTHE CIRCUIT OOUAT. .
ST. LUC 1 E apV~Y. Rt,pRtpA:
TAi~ i~ m,~ d~el~ratioa o1 DoeokiM aad ptis~mbip ia t1N Stat~ at 1~loeida tlwt I am 61in~ tl~ dq ia aeoordana. ~ad is
ooataemiyr with S~etioo 22t.1T. I~7o:Wa Statat~s.
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r~sid~d at ~'7~ - Ho~ne. I baw cLansed m0? domie3la-~--
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aad am aod bave beea a booa Bds resident otths State at ~'belda siaa ~ Z d~y at
~~-1~- .1~ and I:wid~ at ~/9 ' Y» 0 n~ ~ 12
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~ l=.~. /~~2 c~ _ ST. I.UC I E Cou~. Ffoeida.
aad this stat,emsnt b to bs t~kea as m~r deelaration o[ eitiasns6ip. a~ctwl kgat re~idenee aud domie~e in tlis State ot Flo~.
~F fOR THE PURPOSE Of E1lROLLING~ If fOR HOMESTEAD PURPOSES~
CMI~OREN IN SCHOOL~ PLEASE sTATE ~LEASE CNEGKS ~
THEIR NANES2 .
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~ I FURTHEH cEIiTtF'~t tbac I r.at register at my local aaae+ess when cee regi~ravon books reopen. aaa ~aplp .vich au
~ ~ M.ber requiremeats oi a legal resideat ot t6is State.
I FUA1`HE~ CERTIFY that I bsve ao intention to return to m fom~er daniale. and I iatend ta nmaia in
~ e~ ~T . L U C t E . Countr.
lCtt71 .
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NCJ P'?fXl ~ . A.D.19 ~ ~ -
ROGER P01 TRAS, CLERK OF C IRCUI T COt~2T
ST. LUG I E COUNTY, f LOR t DA ~
BY: ~
EPUTY ~ERK
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AGO Form 71 22
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