HomeMy WebLinkAbout0231 ~C,~~~r ~~t~if~ C~'~ Y.J~~Zt~:~~~.-' ~~C~ (~1~~~~~`15~~~~ i
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TO TlIE CL£ItK OF TliE CIRCUIT COURT,
S7. lUC 1 E (~UNTy. Fi,ORIDA:
• Thb is my decl~ration of Domicile aed Citizenahip In the St~te ot Florids that I un filing thts d~y ia ~cco~denee, ~nd In
toniotmitr with Section 2~.17, Ftorida Statute~.
I rru ta~ a legal residcnt o[ ~L S and I
lcar) ~ tsuc.l
resjded at / N•~- ~ C~~ ~NC,€~ /Z--L~ _ _ H~rever. I have changcd my domicilc w .
(8tn~t aad Num~r1
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and am and have btea a bona fide resident of the State of Florida aiace - c~ L~/ ~.1 dsy ot
~ ,19~~.. and I reside at ~ 7 3 t~~ v~`r % /2 L~ • ~
, (Stn+t and Number)
}70 27~ S% L UC_ 1~ _ ST. lt1C ~ E County. Florida.
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and this statemeat Is to be taken ~s mr deelsration o[ citizen~fiip. actud legat re~idertce and domicile in the State ot Florida.
If FOR TNE PURPOSE Of ENROLLING IF FOR NOHESTEAD PURPOSE5~
CHILOREN IN SCHOOL~ PIEASE STATE P~EASE CHECK: ~
THEIR NANES: -
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E I FtJ~tTHER CERTIFY that I v~~i register at my local addres~ when t1~e registration boolc~ reopeo, and comply with all
` otAer reqyiremencs of a legsi rnsident of this State.
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; I FURTHE~ CERTIFY that I have oo intention to return to my foTmer domicile. and I intend ta remain in
• Fr 2 T ~ i_ L i..'C _ ST . L UC 1 E County.
° lCit~) .
~ Florida. permaneaci~.
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Sworn to and subscribed befoce mo this _____.L__~ day of ~U 2 / ~I
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. C~ m7~ Q~.-~ A.D.19 f lEd AMO RECQROE G
f~ LUCIE COUMTY F~A
ROGER PO! TRAS CLERK OF C{RCUf T COl42T AOCER PQ~Tq~c
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ST. LUCI~ COUNTY, fLOR1UA •
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.j BY: ' .
~ EPUI'Y ~ERK
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