HomeMy WebLinkAbout0632 . l~~cl~r~~i~n ~f lD~m~cile a~d Cjri~~nship i ~
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TO Tl1E CL~;RK OF TIIE CIRCUIT COUItT.
ST. LUC 1 E CpUNTY~ FLORIDA:
Tbis js my decl~ration ot Aomicilo ~nd Citizenahip in tho St~to ot F'lorida tha~ l ara Cdieg this day in aceordaneo. ~nd in .
contormity with Scction 2?2.17. Florida Sletutes. ~ _ '
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I was formerl a kgal tcsidcnt of „~,d~c n . /I/ snd l
. (p~y~ lStatel
residcd at ~ 3 ~~f~ S r Nowovcr. I hsvic ehangcd my domicilo to
t and NusnOst) •
And am and havc bc~n ~ bona fidc resident o[ the Stato of Florida alnce day ot
.o~ .19,,i~ and 1 reside at ~ ~?.,s^~ `~j
(Steeet and Numbe~l
Ti¢r'r L ~ ST. Ll1G I E Couaty, Florida.
(pt~)
nnd this statement is to be taken as my decluration oi citiunship. aclunl legal residence ~nd domicile in the State of Florida.
If F'OR THE PURPOSE OF ENROLL ING i f' f'OR HONESTEA~ PURPOSES~
CHILbREN IN SCHOOL~ PIEASE STAYE P~EASE CHECK: ~
YNEIR NAMES:
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I FURT}ICR CF,RTIFY tha~ I will regi~ter at my local address whcn the rFgistration boc~ks reopen, and compty ~vith all
othcr requirem~nts o( a[c~ai resident of this Stale.
I FUitTIICZ CCI~'IFI' ihat I}~avc no intention to returri to my formcr domicilc, and I intend to rrmain in
,.G ~ _ . $T . U C 1 E ~ Caunly,
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; Florida. p~~rmancnti;.
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Sa•a•rrl'arn ,uh«ribcd Leture mo thiv dny of l
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' RnGER P01 TRA CLFRK OF C I f:CU I T COI~tT
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4 ST. LtK I C COUNI~Y, F I.OR 1 UA _
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