HomeMy WebLinkAbout0051 Declaratioon ~ of Damicil~ and Citiz~~ship
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TO TiiE CCI.ERIC OF THE ClttClJ1T COUAT. . ~~O .
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7'ab b aq? dalaration oi Do~nk~ls ard G`iti~~sbip !n tb~ 8ate at ~'Io~Wa tb~t I un tfltas thts da~? tn aecoedanos. aad iA
~oatora~ty? Mith S~ctioa 222.1?. Florida Statuf,a.
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I was t~ a kp1 resWeat af pb f."_T.s,~.,M b V~~ ~~j~ _ ~ad I
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re~ided at __.,,1. ~
D S. L..~.~.1~ LC._ ~to.nwr. I haw eban~ed m~? domkil~ to
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aad am aad baw bee4 a bau Gds redd~at ot tbe 3ts~ ot I~locids sis~ee ~ 1~' dyr ot
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t~~' ST. lUG f E County. Floeida,
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aad tbb atatemeot b to be taken a aq? deel~ratioa ot ati~eaal~ip, ~etnai kgal res~deeiee and domictie ia tbe Stste oi Flodda. i
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If fOR THE PURPOSE Of ENROLIING IF fOR HOMESTEAO PURPOSES~
CHILOREN IM SCN00~~ PtEASE_-lTATE . tLEASE- CHECKt I-"'~ }
YHEtR NAMESt_
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I FI/RTHER CERTIFY ~~t3~ I NI~I tlgiSt@f it D~ jOC~I ~~fC~ ML~D UI!! ='!'$LS~L011 b00~CS [lOpCD• aal eompty w~c6 al1
O~1lt T+lQlifttRlta~t O~ s~!'gi~ !'CSN~cO~ O~ ~$kb. a ~
- I tbat I have no intentioa to retutn t~o fotn~er doanieile. utd I iatead b remaip in
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Sworn to and subsc~ibad bo~ore me thb ~ da~r ot 3=j '1 ~ ~
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A.D.l9 ~--77
f AS ERK Of C IRCU! T COI~tT
ST. LUC 1 E COUNTY, FLOR 10A ' •
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F P u r r ~ F a K j~ic 2;~ YACE ~ 5~
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