HomeMy WebLinkAbout0034 ' Decl~ratian a~ Domicile and Citiz~nship
TO'!HB CI.BRK OF THE C1RCUIT COURT. ~
ST LUC i E Cputv'1'Y. FLORIDA: `;~~~i y~
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~ Tlds b 1nr deelaratioa of Domieile aad Cit~enshiP ia the Stats ot Florida that I am filing this day ia seeotd~ace. and ln
eostoemit~ ~?itA Sectioa 2~:t7. Flarida Statut~s. ~ ~
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I was tormerl a kasl reaid~nt +ot 1~ D• : P fL _~~CL~~ , " GC/' ,F- t.t!-E.t T and I
• . ~ ~ 1CN71 ~~~acs1
~ u_~~ ~l-~ ~Q _~6~ . - How~vee. I have ehanged I r domicite to ~
18t+.~t ~sd N~mbKt
sad am and have b~ea a boaa Gde re~idaat oI the State ot Flocida ~inee d~7 ~
17~~~~ .15~ aad I reside at '7~ ~~,~-x.~'-xtzG~•~ ~~~-x.~• -
(StsMt ~d Nwaber)
,,y ~~u.t.~..~. ~ ST. LUG I E Councr, Ftorida,
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aad tlas aUttcnent ia to be taken as mr deelaratioa o[ citiun3hip. actual kgal rtaidenee and domicile in the State o[ Flo~da..
Ii fOR THE PUR~POSE OF ENROL~ING If iOR NONESTEAD PURPOSES~
CNI~OREN IN SCHOOL~ PIEASE STATE PLEASE CHECK: ~
THEIR NAMES: , .J
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F~~EO ~o RECO~uf~
ST. LUCIE COtlMTY f ~ ~
tf,ifA F01?RAS
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I F'URTHER CERTIFY that : w~71 ngister at my local address when the registration books reopea. aad eomply with all .
otber requiremenu ot a legal resident ot thu State.
I :i CEFtT t t I have no intention W return -to my former domicile. and 1 intend to remsin in
~~J~~02,~ ~~Gt,C i 1Z _ , S T. L U C i E . County.
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Fiorida. petmaneati~. -
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Sworn to and subscribed betore me this °13 dsy of Z~ d~
. . A.D.19~
ROGER POITRAS~ GLERK OF CIRCUIT COUFtT .
ST. LUGlE C4UNTY, fl.OR1UA ~
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j" ~~EPUTY LERK ~
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BOOK PA
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