HomeMy WebLinkAbout0472 uec~~ra~~an ot uonr~ic~~e ana ~~~~z~~~~r~~~
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TO THE CLERK OP' Tt1E CUtCU1T OOURT, ~ . ~
. ST. LUG 1 E OOUtvTY. Fi.ORtnA: ~ ~
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Th~a b mr deelarattaa ot Domtdis and Citizea~hip ie the S1at~ ot Florida tAat I un tding thts dy? ta ~ccordance. and tn ,
coataraity wilh Sectioa 222.17. I~'locida Statutes. ~
I aas to~ a legat t~esideat ot - ~eure ~ 1 ~ ~ C~ u?d I
1Ay) 18tae.)
~~,t :3SO S~. (~~a.?~ (~~v t s - Hoaeves. I lu?ve chaaged my domicile to
IStewt ud Nw~l • .
aad am aad have beea a bona C~dc resideat o[ tbe State o[ Fbrida aincs - day oi
~ -_,:19...1.L. aad I resids at /.~08 • Ru va Hc~ .
(Stn~t and Numeer)
P~r i' ST. LUC I E Couaty. Florid~.
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" aod this statemeat is to ba takes ss my decLration of eit~enship. attual kga! sesidenee and danic~e ia the Stato of Fbrids.
Ii fOR~TNE PURPOSE Of ENROLLING Ii FOR ltONEStEA~ PURPOSES~.
CHIIDREN IN SCNOOL~ PLEASE STATE PLEASE Ci~~LK: ~'~"'-1
T H E 1 R N A M E S 2 ~.,____r~
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376408 A~ 15 9 z~ AM'71 ~
I FURTHER CERTIFY that I~t resister at my loca! addcess arhen tbe regi+tnt~on books reopen, and comply with all
other requiremenq o! s iegal resident oi this State. ~
I FiIRTHE:t EBTIFY that 1 bsve no intentioa to retura to mr former domicile~ as:s! I intend to remain ia
. ' ST . L UC i E _ County. -
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Florida, peraunenci; . .
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Sworn to and subserlbed betoro me tAu ._s~.~ day oi ~
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R G R I AS CLERK OF G IRGU! T GOl~2T
ST. L lJG 1 E COUNTY, f ~OR 1 UA •
. BY: _ . ` . .
EPUTY LERK
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