HomeMy WebLinkAbout0001 D~claration of ~~mici~e and Citiz~nship ~
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TO TtiE CLF.ftK OF THE CIRCUIT COURT.
ST. LUC I E COUNTY, FLOItiDA:
This is my decla~atio~ ot Docnicile and Cit'v.cnshiP in the State of Florida tAst I am Glins this day in accordance, and in
contormity with Sectio~ ~2'L.1T. Floride Statute~.
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I wu tormerly a legal residcnt ot ~ - ~ ~~~t . "~t % and I
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resided at ~ However. I havq changed my domicile to
(Strest ~ad Number) ?
and ain and have been a bona Cde re~ident ot the State ot Florida since day oi
.
'y~' /~_3 ~f~' ~j ~ , ,
19 , and I reside at ~ ~~'~-E~ ~ ~
~ (Stee~t aad Nnm~sr) -
~ ~.fl~,~ ~.,~LC L L ~ ST . l UG 1 E County, Florida,
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and this statement is to be taken as my declaration of citizen~hip, actual le~al residence and domieile in the State oi Florida.
IF FOR THE PURPOSE OF ENROLLING IF_FOR HOHESTEAD PURPOSES~
CHIIOREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~
THEIR NAMES: -
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~ G/r' L , L ~T
• fiLEO ~hU RECuRDt.'
ST.IUCtE COUNIY F~4 ~
RQCfR ?C•~TaAS !
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~ I FURTfiF.R.CF.RTIFl that I will registcr at my local address vnc~n the rcgistration boc~ks reopen, and comply with a!1
F othcr rcquircments of s lega) resident of this State.
~ I FURTI 'i CERTIFY„tht.t I have no intc-ntian lo r~turn to mv tormcr domicile, and I intend lo remlin in
~ _ , . 1. U C 1 E . County.
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Florida, permanenti,~.
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~ CM•orn t~~ and ~ui~scri?=~•d betare me this _ / I day of ~ l._aC_- c~`G G~= '
--~-Q A.U. 19. 7 C~
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3 ROC,ER f'01 Tf;~Sj_ CLERK_OF C IKCUt T_ COUr2T -
ST. LUC I E COUrvTY, FLOZ t UA
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