HomeMy WebLinkAbout0302 ' Qecl~ration o~ Domicile and Gitiz~nshi ~ !
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TO THE CLERK OF THE CIACUIT COURT. 3~~~v ~ I .
ST. L UC i E '
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OOUNTY. FiARIDA: ~
• TAts b n~y deelaratbn ot Oomicile and Citiun~hip iu the State ot Fbrida that I aan fellag thL dar in aecordancs. ~nd In
toafocanitr witb Scctioa 222.17. Florida Statutas, j
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j~?as tormerl a lega! teaItlent ot ti~~e~~A and I
- ' ~ IQt71 lataa)
nsided at How?tver. i hav. ehanged n?y dom~eile co
l3tt~~t aad Num~t1 ~
u?d am aad have beea a boAa fide resident ot the State ot Fbrids aines a` ~.~J'~~ dar ot
18 ~1 aad I resWe at~'~~. C~~`~CJ ~PZ ;
. (3t++~t ~sd Nwneu)
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l~') - Couaty. Florida.
" and this sbtemeat is tc De taken u m~ deeLntion ot citizeeuhip. actual kgal reaidenee aad dornieik in the State o[ Fbrida.
I~' i0R THE PURPOSE O~ ENROLIING If FOR HOMESTEAO PURPOSESi
CNII.OREN IN SCHOOL~ PLEASE STATE PLEASE GHECKt ~
THEIR NAMES:
,~~~F
~Z~ H~~E ~\~~1.~ StJnl
. ST~~UC
E COUNTY F~A.
ROCER POlTKAS
C~t RK CfRCU1T CO
~~r,.,,- . yf n;F1f0
MaR 1 110o AH'7
395~'7
I FUBTHER CERTIFY that I w~l register ai my local addr~.s~ when the registration books reopcn, aad eoraply w~ith all
other tequirement~ at a lega! resident of this State. . -
I Ft1RTHE~ CERTIFY that I Aave ao intention to return to my former domicile. and I intend to remsin in
' T. U C 1 E County.
(Cit~) . .
Fiorida. permancati; . '
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Sworn to and subscribed bciore me thia day oi
- • ~ Q~tC _A~ , A.D.19~..~ .
ROGER PO! TFtAS, CLERK OF C IRCUI T COl~2T
ST. LUC 1 E COUNTY, FLOft 1 A • '
BY s
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EPUTY IERK -
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