HomeMy WebLinkAbout0387 , • • . • • • • ~
Dectaration of Dom~c~le and C~tizenship i~
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ST~ L UC I E COUt~TY, E't.ORI~A:
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?hb b my dsetuatioa ot DomkUe aad Cfti=eeaAip ia tM Stat~ o~ F'brida that I un Gliat tbL dap !a aocoe+daaa. aad ta
eoutaetait~? with Sect~on 22'.IT. E'lorida Statuta. ~
I att ~ c~! a kaal reaideat ot ~ M/~ 2 ' C ~ R?- aud I,.
r~sidtd at ~ 7 l^ ~ v~ r) / G~, lCltp1 l~
. Hawver. 2 haw cbaanged mr domicile to
IstrMt ~od NYmewl ~
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•ad am and havt beea a boaa C~de resideat o[ tfie Stat~ ot Fbcida ~iaa ~ 1~ 7 dar o~
_ ~ ~ .18~ aad 2 rssld. ac ~L ~~r~ / Q ~J ~ r~ 7~ 3 y
Iser+.c a.d Numbe~) +
~tr, ~ = ST. LUG i E Count~. Flor~da,
- ft~cil
~ aad thts statement is to be tskea as aay deelaratioa ot dttzewhip, aetual lega! reaidenc~ a~ dontieile in tl~e State ot Floeida.
if fOR THE ~URPOSE OP ENROLIING IF FOR HONESTEAD PtfRPOSES~
CMIIOREN IN SCH00~~ P~EASE STATE PLEASE CHECKL ~`f~
~TME IR NAMES: ~ ~
I FUBTHER CERTIFY that I w~71 ngister at my locil addr+e~s w~hea the registrsiioa books reopen, aad comply a?ith aU
oth~r requiremeats oi s tegat resident of thu Stsie.
I FURTHE:~ CER F'Y thst I bave ao ~?t~ntioa to return to mr tormer domieile. and I intend to remaia in
_ ^ ` _ $7 . L U C 1 E . County.
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Floridi. permanenci; ,
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~CUNiY . F~'~ ~'~n .S ~n Q •L h ~1
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S.vo~a to snd subxribcd bciore me thu ~ day of 3 3~~ 7
_._.l1L~ ~ A.D.19~, S~~IUC E COUMTr ~~d
aocER P01TRA5
RQGER P01 TRAS_, CLERK OF C IRCUI T COl~2T fF+c c~Rcu~T ccu '
~ED
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ST. LUG i E COUNTY, f LOR t UA • ~AR l I o3 PM ~TB
. aY: ~ . :~9s+~s
_ EPUTY IERK ~
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