HomeMy WebLinkAbout1275 t~~~~~ra~~~¢~~ of ~~micil~~ ~nd Ci~i~~nship
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TO Tli~ CL~;RK Ob' THE CIItCU1T COURT.
ST. LUC 1 E Courrt~t, ~t.onin~: .
This b my dcclaretion ot Domtcilo ~nd Cittzcnship in the Steto o[ Florid~ that I am filin~ this d~y ia aceord~nco. ~nd in .
eontormily with Scction 2~.17. Florid~ Statutes. - ~ '
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I was torm~rl a legal reaIdcnt of p?~-- t` ~ 9" e v'r 1 Q and I
~-X n n ICIt~1 IStatel
n~d~ ~ ~ ~ 1' ~ -t ~ ~ ~ . Iioweves. I havo chRnged my domicilo to '
~ l~tee~t ~ed [donnber) •
3 O Y ~ ~,J c ~y ot ~ i
~ad am and havo bec~~ a bona fidc reside~t otthe Stste ot Florida since
s.~ r ~
~ 1 .19 ~ 5- and I reside at ~ 1~ ~ L S~ '
(Streat u~d Nuaab~r)
` c - ST. IUGfE
_ ~ ~ P ~ ~~r c~a~y, ~oria.,
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~ad this atatement is to be tAken as my declaration of citizenshtp. actual legal residenee and domicUc in tAo Stute ot Floridu.
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IF F4R THE PURPOSE OP ENROLLING . if FOR HONESTEAO PURPOSESi ;I
CHILOREN IN SGNOOL~ PIEASE STATE PlEJ1SE CHECK: ~
~ THEIR NANES: ~
v~ r~ 1 S ~ ~ ~ G_i x? S ,
fllEO AKL+ RECORDE~
. fT. ~UCIE C~UNTY fLA,
ROCE~ ~Ot; q4S
C~E~~ Ct~~~UlT COURT
' REC~!p, n riEO -
~ 5 9 s3 A!i'15
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I FURT}IER CRRTIFY that I wip regi~ler al my loca) sddresa wi~en the registralion books reopen. and comply with xll
other requirc~nenls o[ a Icgal resident ot this Stalc.
I FURTIIE;~ CrI~1I'Y that I havc no intention lo mturr~ to my former domicite. and I inlcnd to remain in
. ~ Le, ~ _ ST . L UC 1 E , Cuunty.
(Citr1 . ~
Florida. permanenti; . ~
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Sworn to anJ sul~ccribed l~eto~ o mo this ``5 dny of
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RnCarR PnITRA GL~RK nF C IRCUIT COt~2T
~ ST. LUC 1' COUNTY, F t.OR 1.UA
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