HomeMy WebLinkAbout0007 Declaration of Domicite and Ci~izenship ~
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7'0 T11E CI.ERK OF T11E CiRCUIT COURT.
ST, LUC 1 E (,p~~. F't,pRiDA:
71~L b my declar~tion ol I?omicib aed Citiuesl+ip ie tM Stat~ d Flor~da tl~st I am Glin~ ti?is day iA atewd~sa, ud iA
~oatormitr wkl~ sectaa ^~:2.17, Florid. slatut...
' ' ~ aed t
1 wa~ t~ a kR~l resid~at a1
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t~e~ided at~~ ^ O~ ~ S~ - Howtver. I baw e my doenicik to
1~1eM ~ N~MrI ~i~
~ed sm and ba~~ ~a ~ bona t'id~ naideot o~ tb~ Stat~ o( Florida siae~ ~ ~y ~
~ G~+S ~ . l' L~ - aod 1 resid~ at ~ ct U~"~~
/ ~d N.~wl
I'r_. h u C'. C~' ST. lUC i E Cou~t~. F1orid..
ICIVI
a~d tha sutewent i~ to De takea a ay decta~ataa ol rit~enahip. uiual kasl residence ard domicib it? tl?a Sute oi Fiofida.
If ~OR ~HE PUR?OSE OF ENROLLIN~ IF ~OR NOMEST[AO PURPOSCS~
CMIIaREN IN SCMOOI~ PIEAS[ STATE ?LEAS[ CH[CK: ~
THE IR NAM[S:
~'/~r ~~J)r~ n~ ~ f'n/c'St~ i
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1 FUJtTIIE:R CE:RTiF'Y tAat 1 will r~Rister at mr locai addres~ when the rcgistrstion books reopen, and complr Mith ~U
otAe~ rcquircmcnts o! a k~al rcsidcnt of lh~~ Statt.
1 FUItT~]1~;t C~KTl~that 1 have no tntrntion to rcturn to my (ormcr domicile, a~d 1 intend to renu?ea in
!~C?~`~ ; ~,~C~f-' ~ S~. ~.U41E Counly.
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Sworn to ~nd sul.serilMd tMtorc mr 1hi~ ~ dar o( f
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