HomeMy WebLinkAbout0529 ' ~c:ciar~~~~~ c~~i I~~m~~il~ af~d C~ ~ .~~s~~~ , :
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TO TIIE CLERK OF TIIE CIRCUIT COURT, ~
~ ST. LUC t E CptTNTY, FLORIDA:
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Th~ ta n~r dcclaration o( Qomtcile x.^.d Citizenahip in the Stato oi F
lorida that 1 am Cding this day ia accorJnnco, •nd in
conformity with Section 222.1T. Flo~id~ Statutce.
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I wu tormcrl a legal ro~ident ot ~($l~.~a~~"~ . ~nd I
ICltr) (St•te) t
resided st 7~3~ a~' u'e- However. I h~ve ehanged my domicile to
(8te~e~t wd NumA~t? • f
u~d am and h~ve been a bona fidc nNsident oi tAc State ot Fbrida aince day ot ~
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.19. - and I ~eside ~t ~n 7 ~
v (3tn~t aad Nnmber) ' {
ST. LUC I E Councy. Floriaa.
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•nd this atatement is to be taken as my declaration oi eitizenship. ectual legal Teaidence aad domicile in the Stato ot Florid~. ~
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IF fOR THE PURPOSE 0~ ENROLLING If POR HONESTEA~ PURPOSES~ ~
CNII~REN IN SCHOOI~ PLEASE STATE PLEASE CHECKS ~
TNEIR NANES: ~ ~
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0 ANQ RECQR DEO
ST.Lf?CtE COUNi~ FLA.
ltOCEfI POITR?S
r~~aK CtRCUI? COUAT
' ? ~ERir1E0
DEC 5 9 ~a pN `11
3bi6499 ~
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I FLiRTHER CERTIFY that I wili register at my local address when the registration book~ reopen. and compiy with all ~
~ othec requirements o[ a legai resident o[ this State. ;
I FURTIiE:t CERTIFY ha I have no intcniion to return to my former dom;cile. and I iatend to remain in :
~ ST ~ UC 1 E County. '
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Florids, pr.rmanenci;. f
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~ Sw•orri to,dod sut?scrit ~~f be~;e~e nzo this ~ day ot ~
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RnC~£R f'01 T?~`:S~ CLE:RK O~_C IF?CUI T CUtfZT ;
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~ ~T. LUC I E COUNTY, f t.C`~t ~ U • ~
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~ ~~~"PUTY ~CLEKK ~
~ , 6GUK ~7~ PACE g~
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