HomeMy WebLinkAbout0492 Declarati~n af D~~nic`i~ and Citiz~nship
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TOTIIECLERK OE'THFCIitGUITGUURT.
S~ L UC 1 E COUNTY. FI.ORIDA:
Thi~ b my decla~ation ot Domicilc and Cilizcn.ship tn lhe State of E'lorida that 1 am filing this day in aceordance. and !n
contormity with Section 2~.17. Florida Statutes.
I~ a..~ r:;••;;rrl e lrg~! srsident ot v T/f G-T o~•~ ~ O n~ • J and I
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resided at 7~~ ~ E~~-~E.? /~i ~/E . ~ .}Iowrver. I heve changed my dotaicile to
IStrNt ae?d NumDe~l
and am and have been a bons C~de resident of the Statc ot FMrida since < G day of •
.18~. and 1 reside at 7 ~ ~ ~ ~ 7~' -ST
(3tre~t u?d Numbtrl
~ n i ~~~,c ST. Li1C I E County. F1orida. .
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and this stalement is to be taken us my decl~ration o[ eltizenship. actual legal residence and domicile in the State ot Florida.
IF FOR THE PURPOSE OF ENROILING IF FOR HONESTEAO.PURPOSESj
CHILOREN IN SCHOQL~ PIEASE STA*E PLEASE GHECKS ~
TNE IR_ NANES:
• ~i~c0 ~FCOR~JED
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~ FURTNER CERTIFI' that I will reRister at m~ lncel addr.esa when the registration books reopcn, and eomply with ~+11
other~requirements of a legat resident oi this State.
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i I FIlRTliF::i CE:RTIFY that 1 hyve no intention to return to my former donucile, and 1 intcnd to remain in
~ - ~ . U C 1 E . County.
i lCitrl . -
Florida, permanenii;.
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CN~orn to and subscrit~cd befnn~ mc this ~ dny ot ~ ~`~%~`f~ j~Lr~
r n.~~. ,9. 7 8 • ~ '
RO~ER F'OI TRAS, CLERK OF C IkCUI T COU~'2T ;
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ST. LUC i E COUNTY, F~Ok 1[)A . '
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BY: ` '
F
~ 1E UTY LERK . ~
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