HomeMy WebLinkAbout0227 D~ciarati~n of t~omicile and Citizensnip
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TO TtIE CLERK OF TNE CIACUIT COURT. . ' ~ ;
~ ST. LUC i E ~ •
COUNCPY. F'LORIDA:
This is my declaration oi Domicib and Citi:en~Aip fn tha State ot FbridR that I am tdtng tAis d~y in aeeordaace. u~d in
eonformity witA Section 22.'.1T. Florida Statutes. '
1~?as to~ u kgal resident ot ~ l 11 C~~' , (1~1 ~~Cl+~-t ~ •nd I
ICU71 (Stat~l
tesided at ~ aC . However. I hava changed my domicik to •
t&eNt wd Numbet!
~nd am a~d have been a bona fide resident ot tAe State of Florida'incs day ol
~ ) t~,j~ _ ! ,.19 t n - ~nd I reside ~t ~ ~ ~ ~ ~:C :
(Ste+~t awd Ndmbcl
1-~3 R~-' ~_t ) C> I~ . , ST . Lt1G I E. Co~nt~. Fior~aa
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aad this statement is to be taken u my declar+?tion oI citisenihip. aetual legal n~idence and domicile in the State o[ Florida.
IF FOR THE PURPOSE Of ENRO~LING IF FOR HOHESTEAa PURPOSES~
CHIL~REN IN SCHOOI~ PIEASE STATE P~EASE CNECK: ~
' THEIR NAMES2
~ _oal An?r~~NeF_
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I FUBTfiER CERTIFY that I ~rill register at my toca! address when thc registration books reopen. and compiy with ~?Il
other requircments o[ a tegal resideni oE this Siate. ~ '
I ~RTIiF.;~ ~E}iTIFY that I have no int~ntion to return to my tormer domicile. and I intend to remain ia +
F-r; ~ ~ CiC i~ , ST . L U C 1 E _ County, '
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Florida. pcrmanenti;. ~
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Sw•arn to and subscribcd before mc this ~J day of ~(~:1`~ T ~...,)T'_ 1C= .~J"f
, A.D. l9. 7 p ~
ROGER RAS~ CLERK OF C lRC.U! T COU2T ~
ST. LUCIE GOUNTY, FlOft1UA • j
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BY S . , ;
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P U T Y L f. R K SOCK ~~acE z~ ~
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