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HomeMy WebLinkAbout0815 r D~ciaration of Domicile and Ci~iz~nship ' . . . • ~ F . . ~ , ' ~ . Y~~B ~ TO Tt1E CLBttK OF TIIE CIRCUIT COUItT. ; • t ST. lUC 1 E • ~70UNTY. F'i.ORIDA: t f ' • ! Tbis is my dcel~ntion ot Domkilsae~d Citisonship in the State ot F'lor~da that I~m fiUn` tAls day ta aooordaneo. ind ia ; ~oatamitr wilh Seetioa 2~.17. Fb~ida Statutcs. _ ~ ~ ~ I wa~ to~mr~l a kgal reaideat o~ o~ r u1 e Q 17 ~ ~ 14~EuJ ~?E.CS E~_ and I • . tC1y1 fstat~l ~ restded at a ~ 7 _~n / L.s~S ~T. }~~~er. I have ehanged mr domie'k to 18tiwt a~d Nw~e~! . • ~ad am aad have bc~a a boea C~de residoat ot t1w St~to o( I~'Iorlda since daj? oI and I residc.c .5/vL. v.q~/0~ r.~T -ST. L l6t~wt wd Nwaeerl ' ~ j~' A_Z".~ ST. LUG i E Camcy. Flor~a.. ICK~1 ' - ` . t aad tlds statcmcat is b bo taken u my deeluattot~ ot eitizeaahip. adu~l kgal naidcnco and domicilc in the Sta/e ot F'brida. ~ If ~OR THE PURPOSE OF ENROLLiNG If FOR HONESTEAO PURPOSESi CHILOREN IN SCHOOI~ PLEASE STATE P~EASE CHECK: ~ ~ "HE IR NAMES: ? . ~ ~ .~.r~.?f ~F.~"L~ - . . • sT lUC1E COUNTY fLA. f - CtERR CInCU~T C URt ~ • ' RECORp VE~c;t~E~ ~ _ ~ . : ~ - ~E8 Z IO 34 ~ '76 { ~ ~ - - 3262~38 • ~ I FUR7'IIER CF:RTIFY that 1 will rc~islcr at my local address when thc rrgistration books rcopcn. and eomply wilh n0 ; other requircments o( a Icgal residenl of this Statc. ~ i _ r ' I FUIiT1iF:t CEitTIFY thal I havc ao intcntion lo rcturn to my forn~cr domicilc. and 1 intend to remain in ~ ' ST . L U C 1 E ~ G,unly. ~ (City) . ~'lorida. pcrmancnti~ . ~ ~ ~ ....~..l..1 ~ ~ ^ . ~ t~..~~ • ~ . ~ `-~-~`.+r . ••,~C~~ ~ ' ~ . sn ~ `G ~ ~ ti ~ a • . ~ . • . • . • ~O : ' C ~ ~ . ~~a h ` ~ iAddr~) ~ 5worn to And +uhscribcd bi~foro mo this ~ dny ot ~ • " ~ ~ l~J. ' , A.b. f0 7C~ _ • , ~ . ~ ROGFR PO~'RAS• C!_FftK Ot' C IRf,UI T GOU2T • . ~ _ . ~ ~T. LuC I E coUNTY, f~OR ~ un ~ ' • - m ~ gY: - . ~ l: ' 1 Y LL'ItK ~ E:.~ 2~8 ~ 813 . ~ ~ ~ : ~ . , ~ ~ - s - - - - _ ~'~~~n~~~~._ '