HomeMy WebLinkAbout0411 ~~~y~c~~~~~
~ 4~99'70
7'U T1tE CI.E1tK OF Tilh: CINGUIT COURT. j
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ST. LUC 1 E _COUNTY, l~I.ORIDA: t
This is my dcclarntio~ o[ I~on~icilo nnd Citizonship in the Slato of Florida lhnl 1 nin Gling t1+is dsy in acconlaucu. and in
contarmily with Sc~ction 1'.`d2.17. Florida Stetut~~y. ~ ~ ~
I was form~r~ a I~ga) resiJsnt oi ,~i/,T/.
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CiIY) (State) +
resided nt ~ ^ ' . llowevcr~ 1 have cl~anged my domicile to
(`~treel u~d Numberl ~ :
and am A~d ha~~c Ucen e bone tidc resident, ot the Steto o! Florida sinca ~ , dsy oi ~
9
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.19~. and I reside st D~ , ~
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~ . ST. L C 1 E Couiity, Florida,
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(Cit~l
and this statement is to ho taken as my declar::tion af citizenship. actual le~al resiocnce ar,d domicile in the State of Florida.
IF F'OR THE PURPOSE OF ENROLLING IF FOR HONES7El~D PURPOS~S?~
CNILOREN IN SClt00L~ PLEASE STACE PLEASE CHECK: ' ~j
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THEIR NI1atES:
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' I F[IRT1I(:l: CI~:RTII'Y thst I wil! regiiter :,t iny local address ~vhen the rc•gi ?ratinr. bcw~:~ reap°n, xnd com; l~• with r.il
i olher mquiremcnts oi a legal r~sident ot thiti State.
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~ I FURTltl:;i (:f:KTIF~ th, t I havc no in:r~tiot~ to r~t.urn Lo m forr:~r clomici'c, and 1 int_end to rc~r~~.~in in
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