HomeMy WebLinkAbout0489 ~ cl ra$ion of Domici0e and Citiz~nshi ~
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To Tt~ c~ntc oF ~iE ctncurr covtrr. , 3~~
ST LUG 1 E . ~,~pvrrrY. FtAntnA: . ~
~ b~?r a«a~.e~ ot n~~b .~a c~u~,~aip m~e se.a ~t ~a. e~i t.,~ r~t~ c~ a.y ~.~a.~. .,~a t~
~oa~atmity with Sectioa 2~.17. I~'lo~ida Statutes.
- I Mra~ tarn~rl a k6a1 cesideat of ~ D!)'I /Yl t~~° ~ C' ~~%~'1 ~ _ C O~~- o, aa~ I •
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nslded ae S'T~ - How~wr. I bave ehan6ed m~r domieib to
tBteMt a~d Nn~sl.r! ~ ~ ~ -
aad aaa and bave beeo a bona Gde resideat ot tho St+~to o( t'brida siacs . ~
t ~ 19-/Y~'/2 ~f .~9_7~ aad I e~eside at ~ t~_ /l/ C G'~rm t
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a!eT 5?i L(.~~ ~ t_ _ ST. LUG 1 E Coun~r. F1orid~,
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aad tbts statemcat is to bo takea u aqr deelarattoa ot eittueuhtp. aetual le~al residenee and doada'Ic in tha State ot Florida. -
If iOR THE PURPOSE OF ENROLLING I~' iOR HONESTEAO PURPOSES~
CNtLOREN IN SCHOOL~ PIEASE STAT£ ~~EIISE CHECK: ~
THEIR NAMESS
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4 I FUIiTItFR CF:RTIFY that 1 will re~istcr at my local address when the rcgistralion books reopen. ~nd eomply with ~Il
i. othcr rcquircmcnl~ o( a kgal residenl ot lhis Siatc. ~
i FUn7~rr::t CEIiTIF'Y that I I~avc no inlcnlion to rcturn lo my forn~cr domicilc. and 1 intend to rcmain in
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