HomeMy WebLinkAbout0961 ' Deciaration of Domicile and Citizenship
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TO T~ CLERK OF THE CIACUIT COURT. ~ {
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ST. LUC 1 E ap~y. ~,p~p~
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~ ?a!~ d a~r. declantba ot Domtetla u+d Citiseeabip ia tb~ State ot Flocida tbat I am 6Ns~ tl~l diU? in acoocdana. ~ad '
toafaadt~ witb Saetioo 2~.17. Florida StatYta. ;
I~ras merl a k`s! nsidept ot D,D l E Td~. ~F.E?
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re~ided at g' / _ No~w~wt. I lu~w ebaa~d ay? domie~s to ~
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u~d am aod bave beeu ~ bona Gde t~e.sideat otthe State ot b'lo:ids siats d+V ot
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lBenK ~d N~~O~e1
r ST. e i c. ~/a _ , ST. lUG 1 E .~o~,,
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~ ~ il~ i~t!/pQAt ~S ~O b0 L~M t~ 111~ ~~I011 Ot Cl~ilMll~. actual kgal raidanee ~nd domie~e in ths State o[ Ffaida.
IP fOR THE ~URPOSE Of EMROIIING If'fOR HOMESTEAD PURPOSESi
CHI~OREN IN sCHOOI~ P~EASE STATE P1.EASE CHECK: ~
• THEIR NAMESS
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~J ~CtERK WRCWt COIIAt
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I FtJIiTFtER CEI;TIFY tbat I wiU register at mr bcal addr~s~ wben the registntion books reopea. and eanpir .rieh aU
j atber reqnire~ats o[ s kgal e~aideat ~ this State. .
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i F'UATHE~ CERTIF'Y thst i hsve ao Intention to retnrn to my tormer domta'k. aud i iotead to remain ia
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AS C RK OF C lRCi11 T COI~tT • '
ST. LUC 1 E COUN'rY, FI.OR t UA ~ -
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EPUTY LERK
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