HomeMy WebLinkAbout0095 Declaration of Domicile and Litizensn~p ~
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~ ST. LUC I_E COVrrrY. FL.ORID~:
Tbis b my deeluatioa oi Domicile u?d Citisee4+hip in tM State ot Fiorlda that t un Wiag thia day in secordaace. a~d ~u
eontormity ~itb Seetioa 222.17. Florida Statutes. .
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I wss tormerl a legal r~ident ot ~i ~a~~ f lSut~1
• ~ Ro~rever. I hav~ e~u+ged m7 domicik to ~
tesided at ~ ~ ~ ~ `
' ~ - day ot
and am a~d have been a bona Cde resident ot the State ot Florida ~inee -
X t1 -19~. snd I reside st ~~,~.Dd Numb.d
' . ST. LUC 1 E Count~. Florid~.
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and this statemeat is to be taken u my dee4ration ot citizee?slup, utual legat residenee and domieile ia tbe State ot Ftoridi.
IF FOR THE PURPOSE Of ENROILiNG Ii POR HOMESTEAO PURPOSES~
CHlLDREN IN SCHOOL~ PIEASE STATE PLEASE CHECKS ~
• ' THEIR NANES:
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` I FUKTHER CERTIFY that I aill register st my local addma wAea the registntioa books reopen. and oompl~ w?ith all
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~ other requiremeats oi a kgal nsident oi this State. .
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~ I FUA'THE~ CEKTIFY that I have no inteation to return to my former domicik. and I inu°a tO n~
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; , ~ ST„ LUCIE Y~
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~ Sworn to a~d subscribed betore me this daY ot G
. A.D.19. ~ 8
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ROGER Pb I AS CLERK OF C 1 RCU ~ T COURT
~ ST. Lt1G 1 E COUNTY, f I.OR t UA ~ .
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