HomeMy WebLinkAbout2560 Declaration of Domicile and Citizenship ~f "
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TO TIlE CLERK OR THE CIRCUIT COURT.
ST. LUC 1 E COUNTY. FLORIDA:
Tbb d any dectuatioa of Domicils and Cltheasbtp la the State of Florida that I am tiling tbL dq is aeoordanos. and is
coatormky with Section 2?.~.17. Florida Statutes ~
~ ~ and I
I wu tom a kga~resideat ai
ICKrI ' Ist.al
resided at o ~ However. I have changed ay? domicile to
IBtrMC.ed .~OKI ~ ~ / / 9 ~ ~ day of
and am.and bays been a bona Gde resident of the State of Fbrlda since -
19 ~ o - sad I reside at f 7`~"` 3 j~~~yZ~(~ ~
18awt •sd N~brl
,t _ ~ ST. LUG 1 E County. Fbcida.
lavl
sad this statement is to be taken as twr declaration of eitiseasbip. actual legal residence and don3eile is tbs State et Florida.
IF.FOR THE PURPOSE OF ENROLLING IF FOR HONESTEAO PURPOSES,
' CHILDREN IN SCHOOL, PLEASE STATE PLEASE EHECK:
THEIR NANES.i -
- - - ~tl•GO AND i~ECaRCF
flA:
L'JCtE ~pUNTY.
- ~ ~ ''t9 FE8 ~ , AID 1 i : 3q ~
.
rL€R!( C:l1 :UI~ uflv~' i
I FURTHER CERTIFY that I will register at my loeai adde+ess when the registration books reopen. and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have ao intention to return to my former domicile. sad I intend to remain in
y...•• J° :~~4..
v~~ ~ .County.
'f fQityl
Il Fbrida. permanenti;. -
I
a
~COUNTy ~ri~odo
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S~irOQ~~
~~F~QUYT'f•~~ 1 ~
Sworn to and subscr'bed before me this ~ day of
~ `~9
ROGER POITRAS. CLERK OF CIRCUIT COURT t
ST. LUGIE COUNTY, fL~21UA
BY
EPUTY LERK
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. ~ ~ ACO Form 71.22
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