HomeMy WebLinkAbout0637 Declaration of Domicile and Citizenship ,
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TO Tt1E CLEItK OF THE CIRCUIT OOURT.
ST. Ll1C 1 E CpUN7~Y, Fi.ORIDA:
lbis Is my deelarstion ot Domkib iad Cltiseaship In ths Sbte ot Ftorida lbat I i?m Wiag t1~4 da~ in aeeordanoe. and in
tonformity with Section 222.1T. Florida St~alutes. ^ - O .
I wu lornnerl • legsl sideat ot f~~ `~~Y• ~ _ ~ I
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resided at , 1 Howwer. I bave ebanged m~p domieib to
ud Num~l
aad am aad bave bcen ~ bau i'ide reaideat of the State ot Florida siace ~r'% day at .
-19.,~... aad I reside at ~~O S /l~~sn tf o L~
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~J~ ,~,e~~.~~ ST. LUC 1 E Connty. Florida.
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•nd this statemeat is to be takea u mr deelaration ot eiti~eaship. ~etusl legal t~aiden~ aad domie~e in the State ot E'lorida.
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IF,iOR THE PURPOSE Of ENROLl1NG If fOR HOMESTEAD PURPOSES~
• CHILOREN IN SCHOOI~ P~E.ASE-STATE PLEASE CHECKS ~
THEIR NAMESS
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I F'URTHEft CERTIFY that I w~71 regitter at my ]ocal address a+1~en the registration bo°1ca nopen, aad compl~ with all
other requinments of a legal resident of this Stste. ~
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~ I FURTHER CERTIE'Y that I have no iatention to ccturn to my [
rmer
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c~ le. aud I intend to nr~u?'~ 'n
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~ Fbrida. permancn~i; .
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~ Sveorn to and suhccribed betore me thi~ ~ daY ot ~~b ~
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~ A.D. l9_ / / ~
~ ROGER POi TRAS. CLERK OF C IRCUI T COURT ~
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ST. LUCIE COUNTY, F~ORI~A
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~ BY t ~ ~ , , " .~ili _
~ . c utY IERK
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~ 6001t `IVJ PACE ~ UJV ~
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~ ~ AGO Form?1 22
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