HomeMy WebLinkAbout0400 ~ D~clarafi~~ o~ i~~miciE~ and C~ ~iz~~ship
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TO THE Ci.BRK OF THE CIRCUIT COURT. .
ST ll1G i E
, .r._._OOt1M'Y. FtAIttDA:
TUs b uV deel~ntba ot Dantcik aad Cttiun~idp tu tb~ State ot F'lorida tbat I~m filtar tbis dy ta ~oordaoa. and ta
eo~ta~aittj?_ rritA Seettoa 2~.17. ~{Orida Statutu.
• I~ras er a k~al e~~id~at ot aad I
resided at . I ~ro ebaaaed aqr doaakile to
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aad am sad have Deeo a bon~ tids sesident ottb~ Stat~ ot Florida ~iaos ` dq?ot
I! asd I r~sid~ at ~ ~
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ST. lUC 1 E ~ Couney. Ftor~aa.
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aed tAis statemene is to be taken as nqr deetaratioa ot eitfzens6~p. aetual kaal r+esidenee ud domidb in ths State ot Fiocjda.
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If~ fOR THE PURPOSE Of ENROCLING - I~' FOR HOM£STEAO PURPOSES~ T
CHILDREN IN SCHOOI.~ P~EASE sTATE PIEASE CHECKS
T H E 1 R N A M E S:
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~ ,~I~EO ANQ RECORDEO
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l FURTHER C~FRZ7FY tha! I~nl! register at m~ Ioeal addr~ wbea the registntia~ books nopea. aad eomplp ~vitb aU
Ot~llt ftQ11~CliAlAtf Ot i ~Cg~ !l3~dltl~ Ot ~$ti~l. , _
I FUR'1'HEii CEBTIFY thst I have no b~ntioa to retura to mr former doraie7e. aAd-I iatend to nmaia in
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Sworn to ~nd subacrtbcd beiore me this v day ot ~ CN
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. - A.D.19.~. 77 ~ 3 ~{,S','
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~ R AS C RK OF C RCUI T COU2T
ST. LUG i E COUNTY, f 1.OR t,OA _
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TY LERK
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