HomeMy WebLinkAbout0282 ~eclaration of t~or~icite an~ Citiz~nship
TO TIIF CI.ERK OF Ttll~: CII~CUIT COURT. a~t3~i'; ~
ST~ Lt1C i E ap~•. ~~,p~~:
This is mp dr:laratian of Domieile and Ciciscnship in the Ftate ot I'lorida tb~t I am filing this dsy in aceot~anoe, and ia
toniormity with Section 222.1?. Fiorids Statutoa. -
I wss lorme~ a kga) residrAt of ~ h'~~.,Q,!? T 4° ~.fl SC RSf' 1/ ~ I
n l(aitty) ISeae+~+~-
residcd at a~ 4 T~ N r~ ~T 1/ e, Hon?ever. I have changcd my damiale to
lStrMt asd NwoOKI ~J • _ .
aed am ~ad hav~e beea a bona tide resideat oi the State oi F'{orida sinee j.,L~1
~ i~ - da~? oI
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_ U Q f e. ~ , ST. lUG I E couaty. Fio,~;aa,
ca~,~
and this statemcnt is to be takea as anr deelaratioA of atiunship. actuallCgal naideAee and domicile ih tbe State oi Fbrida.
' If FOR THE PURPOSE O~ ENROILiNG If FOR HOMES7EAb PURPOSE ~
CHILDREN IN SCNOOL~ P~EASE StATE ALEASE CHECKS"
THEiR NANESS ~ . '
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St. LUC~i: C: ~MTT Fl~
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33223`~ -
I FLJRTIiER CER'f1FY that I w~l register at my local address when the registntion books reopen. and co~nply with all
other requirements of a legat restdent of this Stale.
I F[.~RT~Z CERTIF'Y that I have no. intrntion to return to my tormer domicile. and I intend to remain in
T S 7- ~ Ci' / C'~ ST . L UC 1 E . County.
crcr~ .
Florida. permanenti; . -
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(Addressl ;
Sworn to and ~abscribed before ~~e this day oi /P T~/. .~~„U~ C l L ~
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~ . A.D. l9 7 fi
ROGER P,I TRAS, CL.ERK Uf G tRCUI T COURT ~
ST. LE1G I E COUNTY, F!_0~ t UA \
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