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Declaration of Domicile and Citizenship ;
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TO THE CI.ERK OF THE CIRCUIT COURT. 32413~~ ~
ST. LUG I E ~pu~y. ~-~p~A:
This is my declaration oi Domicile aad Citizenahip in the State ot Florida that I aw filina thi~ dar in ~oordance. and in
eontormity with Section 2?2.t7. Flocida Statutes. •
I*ras Iormerir s legal ses[dent ot ~~6li.r . . and I
t~l (8tw)
resided at iZ ~ s~ , Hmrover. I have changed my domicile to
(&~wt asd NumbK1
and am and have beea a boaa Gde resident ot the State of Flarida siace day of
,19'S ~ - aad I reside at ~ ~
r. ( aad N
~f" `~~~_r. ST. LUG I E ~ ?
- - - - . County.l~'lorida. .
and this statemeat is to be takea as my declaration of citiunahip. aetud kgal residance and domicile in the State ot F'lorida. 1
' IF FOR THE PURPOSE Of ENROLLING IP fOR HONESTEAO PURPOSES~
CHiIOREN IN SCHOO~~ P~EASE STATE PI.EASE CHECK: ~
THEIR NANES2
r
f . LUC1C COUMTY Ft~. '
• ROCER POtTRAS ~ ;
~LfRK CtRCitit COURT :
RfCORQ YfRIftEO • `
J~M ~ ~t 03 ~M'~6 ~
TIi1S !S TO CERTliY THAT MY ~AUGHTER
CINDY LOU TURNER IS~ AN~ HAS BEEN~
A RES I OENT OF FORT PI ERCE~ ST. E 324i3~~
COUNTV~ FLORIDA FOR MORE THAN TEN YEARS.
I FURTHER CERTIFY that I will register at my local address when the re~istration books reopen, and eomply with al!
other requirements of a legal resident of this Stale.
I FU~tTHE~ CERTIF'Y that I have no intention to return to my former domicite. and I intend to remain in
~ ST. LUC 1 E .County.
lCit~1 _
Florida. permanemi; .
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S'ap~ic to~8 su~ae~~ta~ta me this day of ~
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A.D.1976
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ROGE__ PO~A~, CLERK OF C IRCUI T COURT
~.,~T. L UG t E COUNTY, F LOR i UA
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9Y. - ~-L% , s- o a
E P U T Y L E R K BOU~'~T FAGE
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