HomeMy WebLinkAbout0277
. IJ~clarati~n of QQmic~te and Citizenship
. ' • 414939 ~
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N• TO T~i~ C~ERK OF T~i6 C[RCU1T COURT. . ' , ' ~
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• ST. LUC f E ~
COUNTY. FLORIDA:
Thia b mr decleratFon o[ Domicpo ~nd Citizenahip tn the State ot F'lor~da that I am tUng thb dy? ln aaocdance. and in
contormity with Section 22..''.1T. Florida Statutes. ' ~
I was formert a kgal nsident ot • u~ ~e1 • ~nd I
ICuy e tSc.e•)
resided st V" . However. I bave ehanged my domicile to •
tStr+~t ~ed Numeer)
•nd am snd h~vc been a bona Cde re~ident ot the State oi F'torids ~ince dar ot
~
.19~ and I naide at
(Stnet ~e?d NnmAsr)
ST. LUG I E County. Flocida,
tc~cr~
and this statement u to be takea u my declaration ot citizen~l~ip, actual legal re~ideaee and domicile in the State of Florida.
IF fOR THE PURPOSE OP ENROLLING If
fOR HONESI'E/lD PURPOSESi
CHIIOREN IN SCHOOI~ PLEASE STATE PLEASE CHECK: ~
• " THEIR NAHES: .
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Aer II 4S AN'1~
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~ 414939
I FURT1{ER CERTIFY thet I wi11 cegi.ter at my tocal address wt~en the registr:tion books reopen. and comply with all
other requircmcnts of a Icgal resident af this State.
I~TIIF,yZ~tTIFY that~~ve no intention to return to my (ormer domicile,. and I intend to remain in
~ ~C ~1 ~ l• . ST . L u c i E . Cou~cy.
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Florida. pcrmancnti~ .
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Sw~orn to ~nd subscribrd before mc lhis dny of ~
C,~'('' e 7!4~ • ~~{fc~ ~
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ROGER PO I TRAS, CLERK_ OF C i ftCU 1 T COU2T ~ - ~
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ST. LUGt~ COUNTY, FIOktUA ~ :
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EPUTY LERK ~ ~
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