HomeMy WebLinkAbout0658 Declaration of Domi~ile ana ~~~~zensr»p
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TO TEIE CGEAK OF THE CIRCUIT COUR'T. u~3~ (
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ST. lUC 1 E CovrrrY. FtAttm~: , '
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'1'bb b a~l deelantlon ot Domicils ~ed Cit~stuhip ia the 6tai~ ot F'Io~ids that I sat ttlit~ thta d~r ia ateotdsnc~, and ia
~oatormitr with Seetion 222.17. E'lorida StatutM.
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I~?ss tormerl a kgal eeaWent ot -s--.
1~1 le~+al
tnid~d ac ~ f~ ~
j~ S T/~ E' c~ T_ 8aw+~~r, I lu~~ ebu+~ed mp do~aicile t~
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aad ant snd bav~ bee4 a boaa fide rsaldeat of tM State ot Fiorida siae~ ~ C- a~ 1_~~.-da~ at
il~.. aod i ratd. at s• L~ Sf ~ X~ L~ /~i ~1l
f8tiwt ~d N~mb~rl
,~d f? T-' S' 7"'~ L~ c~ r _ ST. LUG ! E Couac~. Ftoreda.
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• aad t6ts s4temeat b to bs takea as my da4ration ot eitt~enship. aetual bgal c+e~ideaas and domia7e iA tlis Stste oi Fbrida.
IP fOR THE PURPOSE Of ENROLLING IF i0R NOMESTEAO PURPOSES~
CNILDREN IN SCH00~~ PLEASE STATE r~EASE CHECKS
TNEIR NAMES:
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I FURTHER CERTIFY that Y ~?ill regisier st my local addr~s~ ~+rhen th~ registntion books reopen. and eomply with all
ot~er sequicements o[ a IegAl rrsident of thu State.
I THE~ CEItTIFY thst I have ao inteation to retura to my tocmer domicile, aad I intend to remain in
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Florida. permaneaci; . '
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Sworn to ~nd ~ubscribod betoro me thi~ `~~L_ d~y ot T• ~ T~ ~ 4 C"
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- A.D.19._.[~
GER_ PO as CLERK OF ClRCUIT COUZT ~ ~
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ST. LUC I E COUNTY, f LOR t.OA ~
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PUTY LERK ~ rt
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