HomeMy WebLinkAbout0492 Declarat~an o~ Damicile and Citizenship
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1'0 TH~ CLERK OF THE CiRCUtT (?OURT~ . ~
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ST. Ll1C 1 E ppV~y, ~,p~DAs .
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Tbt~ Li m,~? deelantion ot Domicile and CitisensAip In tho Stato ot Fiorida that 1 un GUag this d~?y in aoeordu~ce, aad ia
oontotanity with Section 222.1T, Florida StRtutes. .
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I~ras (orm~rl a bgsl realdent ot / p ~ , , I .
lClt~l 1&~l
resided at 1 ~•~~p-l~-~.,. _ Ho~reree. I~uw chaag~ed a~? domisils to
t8tn~t ~sd Num~! •
uid am and have beea a bon~ fide tesident ot the Sbte ot Fbrida sincs dqr oi
]9 and 1 restde at ~ ~ ~G~i ~
: l8tn~t w'1 wab~l
ST. lUC t E Countr, Fbrida.
iCk~l
" aad thfs statement is to be taken u my declaration ot tit~xeaship. actual kgd residenee ~t~d domicile in the Stato ot Fbrida.
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It POR THE PURPOSE O~ ENROLLING " If i0R HONESTEAD PURPOS i ~
CH!lOREN IN SCHOOL~ PLEASE STATE PLEASE CNECKS
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r ~o,~o RECOR Eu
_ a~ tvc~~ couNrY
aooE~ Por~R~s
C~ERK CIRCUIT COURT ~
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I FUItTHER CERTIFY that I w~! register at my bcal addres~ when the registration books reopen. snd wmply with all
other requiremenq o[ a Icgal resident o[ this State. '
I FURTHE;i CERTIFY that I hsve no intention to return to my former domicile. and I iatend to rcmain in
" ST . L U C 1 E County,
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Fbrida. permanenti~. .
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SK~oco !o and subsc~ibed bcloro me thti day of
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A.D.19~ r - .
ROGER POITi . CLERK OF CIRCUtT COUtT .
ST. Lt1C I E COUNTY, f LCN21 UA ~
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EPUtY LERK
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