HomeMy WebLinkAbout0321 Dec~aration of Domfcile and Citizenship
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TO T}iE CI,ERK OF TNE CIRCUIT COURT, ~ ~
ST. LUG 1 E__ CovNTY. FIAltIDA: ~
This is my decluation ot Domicile and CittzenaAip in the State oi Flocida lhat I am C~liag thts dq? in aeeordaace. and in
tonformity with Seelioa 222.1T. Florida Statutes. .
I was former a kgal nsident ot V~~~ E - ` u~ I
~ IC1tp1 l&atd
nsidad st .j. D3 ~1o,~r~Y~~a~ /Ql I~E - HoMever. I have chang@d m~? domieile to
(sa..t.oa NwreK! cS~PI, tg ~~~8 a,q? ot
and am and luvo been a boaa C~de sesldeat o! ~he State ot Fbcida sinee
,sSE~`TE/yY~~ .-19.,~.. aad I reslde at h~ C'AM/~/o ~TiPE~T
tsu..c..a H~me.r~
ST ~ UU~ ~ , ST . L UG I E~ County. Florjda.
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aad this statement ts to be Wcen as iny declualion oi dtiua+htp. aetud legal sesideaoe and domidk in the State ot Fioeida.
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Ii.iOR~ THE PURPOSE OF ENROll1NG Ii POR NOMESTEAO PURPOSES~
CNILDREN IN SCHbOL~ PLEASE STAYE PLEASE CHECKS
THEIR NAMESi
r: y~ r HECOROED,
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I Ft)RTIiER CERTffY that I~rill register at iny loca! addre.~s ~rhen the registntion books reopen. and comply ~rith all
other requirements oi a kgal resident oi this State.
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f I FURTNE,'t CERTIFY that I have ao intrntion to return to my forrner domieile, uid I ialend to rems~n i~
5 T. L U C 1 E County?
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s Florida. permanen~i~ . .
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~ Sworn to and subscrit~ed betore me thi~ ~L.___._ dsy ot -
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~ Q/~~ . A.D.19_ ~9 -
~ I T GOURT ~ -
~ ROGER POITRAS. CLERK OF CIRCU
a .
ST. LUGIE COUNTY, FLORIUA ~
8Yt
E UTY LERK .
. aooK 3t~3 320 _
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