HomeMy WebLinkAbout0801 Declaration of Dornicile and Citizenship
35~6355
TO TNE CI.ERK OF THE CIRCUIT COURT.
ST. LUC 1 E apurrry. ~pt~~:
~ Thb b avr d.e~aracion ot Oomkile and Citt~e~ship ia tM Saa d Florida chac i am Gling chb dsr ta aeooedancs. and w
eoafoctaitr with Seetion 222.17. F'loirida Slatuta.
I ~ra former a kgal tesident of ~}-~1~.~, n1~J v•c~~~• and I
7- ~q~~ e.a~
t+estded at 3n ~ a~~g~~/ D~ , v~ ' - Howev~r. I lu?v~ e6aa~ed mr domidie to
(Ser..t aed Nw.bK) .
aad un aad have been a bona t~de resident of the State ot Fbrida since ~ ' ~
1~~.. and I reside at / 9~a Q d'Q '~~~r
(8~t Md Nosb~l .
~LG ~ - : ST. LUG 1 E Count~.Ftorida.
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and this statement ~S to be taken as nq? deelaratiou ot eitizensbip. aetual k~aal residenes aad ~iaue~ ~e the State of Florida.
IP POR THE PURPOSE Oi ENROIIING- IF i0R HONEStEAO PURPOSES~
CHII~REN iN SCHOOI~ P~EASE STATE ~~EASE CHECKS ~
THEIR NAMESS _
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~ 35~355 .
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I F'URTHER CERTIFY that I ~n71 e+egister at my loal addnss wbep tl~e ngistratlon books reopea. and compl~? ~rith all
~ • other requirements of s legal resideat ot this State.
I FURTNEZ CF~TIFY that . have no intentioa to return to mr former domieik. and I intend to nmaia in
, ,ei^~ , , , S T . L u t ~ E _ Camty.
1 71 .
Florida. Pernunea~i; .
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,Sworn to andiubscribed before me this _L_ da~ ot /
-A.D.19 77 -
ER I AS C ERK OF C IRCUI T COl~2T
ST. LUGIE GOUNTY, F~ORtUA •
. 8Y: ~j • y
. EPUTY ERK f
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~0~~63 n~t ~87 '
AGO Form 7t.22
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