HomeMy WebLinkAbout0294 ~ ~ ~
Deciaration of Domicile and Citizenship '
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338402 ~
TO TNE CLERK OF THE CtRCU1T COURT.
. ST. LUC 1 E GpU~y. ~,p~p~:
Thfs Is my declaratioa at Dom~Cils aad Citisenship in the State o[ F'brlda that I am Aing tDis da~? ta aoeordanos. and ia
eoaformitr witA Section 222.1T. Florida Statutes. . ~
I was form~e_rl,~ a kgal resideat ot . I 3
1(~t71 l ~
resWed a! ~~y ~ - However, I have changed my doanicile to
(Strwt wd NumDar)
and am and have been a bo~t C~de resident ot the State oi Florida since ~ ~ ~ day at
_ 19 ~ and I reside at ~ ~ b ~ ~
~ ~ • ~ (Stewt ud Nomb~rl
. ST . L UG 1 E ~,,,,~y.
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aad this statement is to be taken u m~ declantion oCeitisenship. aMual kgal reaidenee and damicile in tl~e State ot Fbrida.
IF FOR THE PURPOSE OF ENROILING IF FOR HOMESTEAO PURPOSES~
CHItOREN IN SCHOOL~ ~IEASE STATE PLEASE CHECK:
THEIR NAMESS
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WCI~E C RECORDED '
ROCER PpITRAs
~-~a~.~_c~v`.~.-`-..SL_
CI.ERR y";RCUfT COURT
REC~R.~ VQRIFIEa
' Z~ 3 oz PH'?6
338402
I FLIRTHER CERTIFY that I will register at my Ioca! addresa when the registntion booka reopen. snd eomply wit6 all
other requirements of a legal resident of this Stute.
I FUR~
~ .I;TI th I lyive no inteation to return to my formcr dowicile. and I intend to remain in
`t'. ~ •
- ~ ST . L U C I E . Coualy.
; - t(.ticy?
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~ Florida. permanenti; . ~
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Sworn toani~pscribed betore me this ~ dny of
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; • y~"~'~ f~7~A,~s,~ CLERK OF G IRCUI T COURT
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