HomeMy WebLinkAbout0806 . . . .
~.c ,
D~ciaration of D~micile and Citi~~nshi~a
~ ~ . 439552
TO Tt1E CLE1tK OF THE CIRCUIT COURT. ~
ST. LUC I E CpUA1Tl[~ F'I.pRIDA:
This is my deelaration ot Domieila ~nd Citizenahip in ths State of Florida tbat I am f~ing this dqr ia ~ccordaace, and In ~
,
confarmity with Seclion 222.17. Florida Statutes.
I was formcrly a legal re~ident o[ ~ L~J1~--s~- , '~J~n'?)'t- and I
1(~7) lStat~
resided~at ~ - Ho~rever.I have changed nqr domicib to
IStre~t ~ad N~mesr) .
.nd am and have been a bona Cde resident ot the State of Florida sincs _ X•"' , da~? ~
t"~l n_h ~~f/~ .19~.1. aad 1 reside at ~
(3trsst Alumber)
s.~, Q~ Q~c~2 L'.E ST. LUC 1 E County, Florida.
tc~1
and this statement ia to be Wcen u my dec4ration of citiunship. adualleg~J nsideace aad dornie7e in the S4te ot Florida.
IF.FOR THE PURPOSE OF ENROIIING IF POR`HONESTEA~ PURPOSES~
' CHIL~REN IN SCH00~~ PIEASE STATE PLEASE CHECKS ~
tHE1R NAMES:
( Jt>
• F' ~~D AND RECOKDE~..
~-=ir`E :~~~U~T=,E.Ci .
~39552
,Z9 k~~ ~ ~M t~ : 06
.
T~ • ! l
~ S:t;.ji~~' ''l)' .
~,L~r?~', r.iNL.~.~
!i _
,
~ .
,I
~ I FURTHER CERI7FY that I wi'll register at my local address when the registntion books reopen. and eomply with all
othcr requirements oi a legal resideat oi this State. _
~ -
t ~ I FURTHER CERTIFY that I have no intention to return !o my tormer domicile, and I intend to remain in
~ " ' - . UC 1 E ' ~ County.
~ ~ 1(st~l .
' Florida, permaneati;.
_ ~
~ . ~
~ ~
~ - Nam~) • . '
~ _ ~
~ ' (Addr.a)
~ S w orn to and suburibed betoro me this day of p A1 ,f'd
~ A Pa-! L , A.D.19_ i
~ ~9 ,
~ ~OGER P01 TRAS, CLERK OF C IRCUI T COl~2T . :::??'~i,;
•
~ . . '
~ S~' . L UG I E COUNTY, F LOR 1 UA ~ .
~ ' : .
~Y: . ~ ~ •
" EPUTY ERK .
~ . - ,
~ ' ` 805 ~
~ • ? ~ r ~f~GK rr~~.~-
~ ~ ~
~ ~ ' ~ A(~O f~~~..;r ~
;
_ , .
w.<- . . . _ . . . .