HomeMy WebLinkAbout0975 _ /
Declar~tian of ~~m~cil~ and Citizenshi ~
P
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TO THE CL.ERK OF 7`HE CIRCUJT OOURT. .
G ~ ~IfrC;S ~5~.,1~~~~,~
C OOUNTY. ~LORIDA:
This b mp dedaratbe ot DoaileD~ and (~itlunsWp ia tM Stat~ o~ ~lorida t}ut I~m tDin~ 1hI~ da~. Ia accordane~e. :nd in
conlormftf writ6 S~etb~ 22Z.11. Florida SLtut~s.
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i was (orme a k~al res~deat cd CZ ~1 ` u~~ S C c. 7 c~ ~S i , S~; r; ~ u r d i C T G~~ and I
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. re:ided at T'i 1('0 r/~ G~ ~ c' ~ l~: ~i~ r n l c, <~~G~ ~~~.t' f~_ Now?ever~ I haw cbantcd m~ dornicDc to
lsti..t ~ Nrm?K!
and am aad havc bes!+ t~de »iidsat ot 1he State of Fbrida aLus ~"~i ~ ~ i{ da~ of
J~1 Cr r c~ , l~ aad I restde ~t /~3 `i ~1 C c u ~ 7~
e ~ ~ / iBerMt a~A Nn.mbr)
- l'cr~ j; ~rce , S~, ~1~ 1-, uc~
Count~. Florida.
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and this ~tatsmeot to b~ tak~e u en~ detlaratios o~ citiunsl~, tettul i~~t! re~ident~ and domieIi~ in the Statt ot F{orida.
If for the purpose of enrolling
children in public school, pl~ase ~
state their nanes: ~
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I FURTHER CERTIFY tAat ~ ~rtU re~istsr at m~ {oul addrcss when tAe rt`istratbo booki reopen, aad eomply ~ith all
; other requiromenb af a k~al re~ident ~ tf?ts S4te.
E I FURTHER CERTIFY that 1 hav~ oo intentioa to reture to m~ fortner domic~7e. and I intend to remain in
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= H~~ I - CIRCGjIT OQCJF~' ~,aome - print
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