HomeMy WebLinkAbout0391 i r tion of Dornicile and Citizenshi ~
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ST~ lUC I E QpUt~TY. Ft.OtstDA: i
Tl~b b a~r deelaratioA ot Dank~e ~ad CitiseasAip ia tM Stst~ ot Flo~ida~MM! I un IDtas tbls dqr iu ~oordana. aad ts
~o~taraait,~ witl~ Sation 422.~7. ~'lorida Statutes.
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I w~s nxr • kss! iwWeat ot . f~4 ~ 1~ E'1 ~..~.-..~..-.-'7' , t
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er~ided ae ..1 r7 :S ~r~ ~
. $e~r. I b~w ebaaged o~r domieas to
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and am and hare beea a boua tide r~idsat otthe Statie o~Ffoc~da siaa dN~ ~
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19.~2.. aad I raid~ at ~ ~L~ l~ S ~
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a-r S T L r.~ c~E ST. LUG i E Cow,ty, Florida.
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and tbts statement is to be takea aa aqr dadsratloa ot e~easAip. adnal k~al resi~cnoe aAd domidle io tt~e State o~ Flacids.
If fOR THE PURPOSE Of ENRO~LiNG IF i0R HONESTEAO PURPOSES~
CMILOREN IN SCHOOL~ PLEASE STATE ?~EASE CHECK:
tHEtR NAMESt ~
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CIRCi~IIT
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I FUItT~iER CE~TIF'Y tbat I~rill registes at m~ bcal addr+ess arbea tbe registratioa booics seope~. and eompl~? ~vith all
ot6er requinaieats ot a kgal sesideot ot t6is State. .
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; I J~'IJRTHE~ C,ER1'I~i thst I have Ao iritention to retaru to m~r famer domieik. aad i Iatcnd to nmaia in
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Sworn to and subxribed be[ore me tbb ~ day ot
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! A.D.19~~
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R i TRA . CLERK Of
G IRCUI T GOU2T
ST. lUC1E GOUNTY, fLORiDA ~
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. , uTY LERK `OOK~~Pa~ ~ ~
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