HomeMy WebLinkAbout0862 Declaration of Domicile and Citizenship
To~ cc.EeK oF~ cn~currcov~rr. 3~56?39~'
ST. LUC 1 E op~y. ~,p~p~:
• Tbis b aar decl.rseion ot Domieik aad Cicisenship fa cM Saa ot F'lorida chac 1 am filiaa tbL day ia .ocordance. and ia
~oatamity rvith Seetioa 222.17. Fb~ida S4tutea.
I was t~ a kaaJ resident ot !Y?
A~-~ i ~ o~~ rri ~L.~~- ~ `-Z / ~ ~.',-1 e and I '
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resided at ~(1Zg ~1~ ~ f - Howevee. I luve ehanged aqr domieik to
~sd Nnmbu) ~
tad am and lsave beea a boaa fide resideat oi ths Stste oi Fbrida siaee a 9 _ 1 day ot -
In ~ ~ r u , Is ? 7. and I reaide at 1~(o Lo ~)~~l
• , ISt~t ~d N~e~el
L~c ~ ~ ST . L UC I E Coancr. Ftorida,
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aad this ststeeaent is to be takeA as my declaration ot atizeaship. setual kgal eesidence aa~ domiak ia tl:s State o[ Florida. ~
Ii FOR THE PURPOSE OF ENROLLIHG If POR HOMESTE110 PURPOSES~
CH1lOREN IN SCNOOL~ PLEASE STATE PLEASE CHECK: r~
tHE1R NAMESS -
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I FUBTHER CERTIFY t6at I w~iU register at mr local addresa ~?hen t6e registration books reopea. and eompl~ ~?it6 ati
otber requirements ot a kgal resident of tbis State.
~j I F[JBTHER CERTIF'Y th:t I have no iatentioa to retara W my toraier domi~ik. and I iatend to nmain in
'I ~ t Q~ l~ Q , $T . L U C 1 E County.
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Fbrida. permanenti; . •
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SNO~~~,~~-~ ~rom~ 3~ ot
A.D.19 7~T _
ROGE P01 TRAS. CLERK OF C IRCUI T GOl~2T
~ST. LUCIE COUNTY, FLORIDA •
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EP tERK ~
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