HomeMy WebLinkAbout0756 Declaration of Domicil~ and Citizenship /
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T~is b u~ deelarsztoe ot Do+nieile and Ci~i:eas~ip ia tM Seaa ot Flo~id. tbat i am Nin~ cAis dar i~ aeeadRna. and i,~
oonlormity with Sectioa 222.17. Florida St~tutN.
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I Mras tormerl a ksat ra4ideat ot ~ *
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nsided at J` . Howewr. I bave tbanged my domicile to .
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apd aea and hs~re b~en a boaa ticM rosident v~ tbe Stat~ ot ~'brida siac~ 3 dar ot
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aad u?ia scaameat is co be ~aken as mr daclarstjoa at dci~aslup~ aetual ksal eesidenee and domici7s in t~s 3tate d Florid:. '
~F f4R Tlt~ PURPOSE OF ENROLLING. ~F FOR NOMESTEAO PURPOSES~
CNII~REN IN SCHOOL~ PIEASE STATE PLEASE GHECKS_. ~
. TMEIR NAMES.
4~p AMD RECpROEO
~UC1! COUN1Y FtA.
OCEp POITRAS
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I F'tJB1`HER CER'TIFY that I w~11 register st m~ locai address ~vheo the registration books reopeti; and comply ~?ith aU
otber requiremeats ot a kgai tesideat o[ this St=te. ~
I GU~~CT~E_,r4'L' 4~l1-~th~t I have no intention to return to my former domicile. s~d 1 iutead to remain in
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Florid~. permaaeati; .
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Sworn to and subseribcd before me thu day of
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ROGER. PO! TRAS, CLERK OF G IRGUI T COl~2T
ST, LUGIE COUNTY, FLORtUA ~
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EPUTY LERK
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