HomeMy WebLinkAbout0649 ~ D~ciaratior~ of t~omicil~ ar~d Citiz~~ship
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TO TIiE CLE~tK OF TlIE CIRCUIT COURT. ~J~U
ST. lUC 1 E CpUPiTy~ FLORIDA:
Thf~ b mr deeluation o[ Domlcite aad Citizcn~hip iu ihe State oi Florida tbat I am Ciling thia d~y ia aeeord~nte. and ia
~oaformitr with Seetion 222.tT. Florida Statutes.
I~?a~ lormerlY a kgal resident oi ,~~lL~'~.~~~~'1 ~ . / h-~ , and I •
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resjded at ~ ' • However~ I bave ehanged tnr dar+ti~ite to
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aad am and have beca a bona Cde nsident ot tbe Sbte of Florida ~ioce dar oI
19.~. and I reside at '
• (Strect wd Numesrl
~ ST . L UC I E - County, Ftorida, ~
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aa tt~is stateinent ~S to be taken ~ mr declantion of citiur?~hip. actual legal residenee ~nd domicile in t~e Stato oi Florida, ;
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~f FOR THE PURPOSE Of ENROLIING I~ fOR HONESTEAO PtIRPOS~S~ ~
CHII.OREN IN SCHOOI.~ P~EASE STATE PCEASE CHEtKt r,% ~
tNE1R NAMESS t ~
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af.C0~0 vEpliiEp c0u~ .
pw ly 10 03 ~M'16
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I FURTHEft CERTIFY that I will register at my iocal address when the regisirateon books reopcn, and comply with all
other requirements of a legal resident of this State.
I R E~ CERTI hat I ha e no intention to return to my former domieile. and I intend to remain in
ST . L uC 1 E , County, -
lCit)1 .
Florid:. permaneatl;.
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Sworn to and sub~eribed betore me tbis day ot
. - d v'
, A.D.19 7 ~
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~ _ROGER P01 TRAS„ CLERK OF C IRCUI T COURT
'"ST. LUC I E COUNTY, FI.OR tUA ~ - '
BY: 8~~~~6~ Fa~~ ~4f~
~ . EP LERK I ,
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