HomeMy WebLinkAbout0420 ~ ~~ch~ra~i~~ of ~a~oe~~~ ar~d ~ii~iz~~~:~hi~
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TO T11B CLERK OF T11E C1RCUIT COURT. '
ST. LUC 1 E ~p~~. Ft,pntn~:
~ This b my deelaration ot Domicilc and Citizen~hip In the State ot Florida that I am Citina thts dar in accocdance, ~~d in •
contormity with Scclion 22"..17. Flo~id~ Statutes.
~ I ~ru formcrt a legal tc~dcnt ot G RD ~~'d y'~ and t •
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tesided at 5 3'y ~ R v F
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o~ P/qK K l.li l9`/ - Howevdr. I have cAangtd eny domieilc to ~y
lScr.~t and N~me.tl . .
aud am and Aave been a bona Iide resident ot th~ State ot Florida si~cs f..
~ -d~7
~ ~ ~ H , ~9 r~ - and I restde at ' ~uT/~ 4C ~ ~ N ~ v~
1SteNt ad Numserl
~a ~Q T/~/~ K C~ _ ST. LUG 1 E County, Florida.
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' ~nd thi~ atatement is to be taken as my declaratioa ot eitizenship. actusl legat rasidence and domicile ia the State oi Flo~da.
If fOR TNE PURPOSE OF ENROILING IP fOR HONESTEAD PURPOSES~
CHIIOREN IN SCHOOL~ PLEASE SY/lTE P~EASE CNECKS r,~~
tHE1R NANESi l r ~
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f lE0 AND RECOROED FIL
S~• luCiE COUNTIf FIA. ~ ST. CiE COUMtr fi,a.
ROCER POIIRAS FOC~~ Pn~TRA$ :
CIERK~CtRCU1T COURT . '
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'i I FURTIIF.R CERTTFY that I wilt rcgister at my local addres~ when the rcgistration books reopen. and comply with All
~ other rcquiremcnts ot a IcEal resident o[ this State. ~
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I FUItTII~:i CERTIFY that I hnve no intention to return to my former domicile. and I intend to rcmai~ in
~ • ' , S Y. L u C I E , County.
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Florida. permancnti~.
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~ Sworn to and'subsc~'1ird~~~se~mo l1~is dRy o!
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R4 ,ER f'0l1RIlS. CLf_RK OF' G IRCUI 7 COl~2T :
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ST. L lK I E COUNTY, F l.Ok 1 UA ~ ~
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