HomeMy WebLinkAbout0452 1 r tion of Domicile and Citizenshi ~
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TO TH6 CI.BRK OF THa CIRCUIT OOt1aT.
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s ~ r ay d~elae~tios ot Daa1dM and Citt~nd~ip is e1N St~ al 1~lo~id~ tAat I ~w 8tia~ ebi~ dy? is ~eeo~daaa. aad i~ ~
eo~to~it~ MitA Ssttloa 22a.IZ. Florida 8tat~f~s.
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e~Md at ~~CH Q/p_1~ ~L iA - 8owwr~e.I baw eluas+~d aqr doa~ib to ~
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aad am aed lisw bMa a boaa Gdf:+wid~t altM 3tat~ atFiocida slaa ~ ,..__d+U? ot
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" aad t1~s stat~a4ent is to be tak~n as aq? d~dsration aI dtizsmhip. utud le~at raideae~ aai doadetM ia t1M State aI Fbcids.
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Ii i0R TME 'URPOSE Oi ENRO~~ING IF ?OR MOMESTEAO,~ ~OSES~
CMI~OREN IN SCHOOI~ ~LEASE STATE '~EASE CHECK2 ;
TNEIR NAMES:
fILEO AMO RECONOED
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C! ERK CixCUIT COURT ~
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; I F'~JRTHER CERTIF'Y tlut I rn7t register at tny {oal address ~?hea the registratioa booics e+eapea and oompl~ with a11
~ otl~et requirenKpts ot a kgal resideat ot t!w S4te. ~ - -
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E I FUIiTHE~ CEItTIFY that I 6ave ao iatentioa to ratusa to°~' former iormdk. aod i fntend to semsin in
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? Sworu to and aubxrlbed before me tl?L~ ~ dar ot CS c n~ 5~ N G fl e t1 _~L-~
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; ~tOGER P01 TRAS. CLERK OF C IRCU1 T COlx2T -
~ ST. LUGIE COUNTY, FLORIOA ~ .
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