HomeMy WebLinkAbout0405 f • ~ • ~ • ~
_ Deciaration of Dom~cile and Citizensh~p
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TO TH~ CLERK OF T1IE CIRCUIT COU12T.
sr. LUC 1 E c,ovrr,~r. FIARIDA:
This Is my deelacation oi Domkile and Citiseaship Ia the State oi Fio~ida that I am Gliag thu day ia secordance. and in
oontormily w+itli Sectlon 222.17~ Ftorida Statutea.
• Iav~st~~akgalresidentot ~'1 t~S~GG• ~A/Y ~ ~-"L~~~o? 5 _andI '
iwtYf 18i~c.)
resided at l•t~ - However. I Uave cbaaged my daaia7e to .
(3wet nd NwobK) • l
aad un and bave bsea a bona lide resideat o[ tho State o! Fbrida siaes U~ ~ y ~ day ot
%-19- - and I reside at L~D7 S~ f' ~S~/~~ Z•~i C f -
v lSNwt ~d ru~bed
/ c'~~ S~~v~~ ti ST. lUG i E County. F'~ozida.
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and this atatement is to be taken as avr decluation ot cithenship. actual legal residenee and domicib ia the State ot Florids.
IF FOR TNE PURPOSE OP ENROLIING Ii fOR NOMESTEAD PURPOSES~ _
~ CHILOREN IN SCHOOI~ PIEASE STAtE PIEASE CHECKS ~
THEIR NAMESS_ . . _
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I FURTIiER CEEtTIFY t6at I wn71 register at my local address when the registration books reopen, and oomply with aU
~t~er requiremeuts at a Mgal resident ot this State.
j I FURTIi~B CE TIFY that I have no intention to return to my former domiFile. and 1 intend to remain in
' s R~ -~it ~G- L'/ t; , ST . L U C I E County.
ICitr) . - .
Florida. permanenti~ . '
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Sworn ta and subscribed bc[ore me tl?is ~ duy of _
' ~ - ~ A.D.19
76 -
ROGER P~ITRAS_„ CLERK OF GIRGUIT GOI.~RT ~
ST. LUt;IE COUNTY, F~ORIUA
BY: , ~
~ EPUtY LERK Yq{
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