HomeMy WebLinkAbout0710 u;~~33`~.'~~
t~~claratic~n of ~Domi~ile and Cit~z~nshi ~
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TOTHE ~RK OF'1'~~E CIRCUIT COURT. .
_ ST. Ll1C 1 E OOUtv~t'Y. FLORIDA:
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~ v my dccluac~+ ot Domk~le ,u,d Ctetsons~tp in tbs S~e ot Floeid• ~hac i am G~n~ eh4 da~? in aecoe~daac.. .nd ia
confi~cmitr wlth See~• Fbrida Statut~. . .
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1 wa~ formc, r1Y a kgsl raside v and I
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tesWed at Howen~~ ~ I~ave ei~
. ~ 18t~wt ~sd NYSb~r) _ ~n8ed ~A~? damicile to
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and am aad fiave beee a boaa Gde rcatdeat oi the St+~te ot Fiorid~? siaos d~r ot
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ST. lUC I E Couaqr. t~'for~d.,
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aad tl~is statcmeAt is to be tskca ~s aqr declantion ot citisensl~p. utual kgal residenee and doa~e ia the 3tate ot Fbrid~.
' IF POR THE PURPOSE OP~ENROtL1NG IF FOR HONESTEAD PURPOSES~
CHItDREN 1N SCHOO~~j PtEASE STATE PLEASE CHECKS ~
7HEIR HAMESS ~
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~ ST tbC E COU
TY FLA. ~ - -
C~E KCC RCUIT COt111T
~ RECOpO YE~+IftEO...~~, ~
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1 FUBTIIER CF:RTIFY thst I will registcr at my locdl address when tbe rcgistralion books reopcn. a~ad eomply wrilh a0
other requirements of a legal resident of tbi~ State. •
l FUlt1'IiEZ CERTIFY that I have ao intcnlion to relurn ta my former domicile. and I intcnd to remain in
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Florida. permunenti; . - - ~
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y . ~ ..+r..r..`rr~.lrb ~ ~il fr~
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l~w6F't1•t~r~M'd`subscribc?d bctore me this ~C'?+~.~,+, day o! ~~t;"`.~ ~~~-'t~=T._..~..~' ..e
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ROGER POI TRAS~ CLERK Of C IRCUI T COURT •
ST. LUC I E GDUNTY, F1.0(21 UA ~
BY: ~ ~ .
~PUTY I. 1 ~
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