HomeMy WebLinkAbout1591 B~~cQ~r~~i~n ~~o ~~t~c~~B~ ~c~a~~rt~~~a~
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TO TII~ C1.LItK Ot' TIiE CtRCUtT COURT.
ST • l~ UC 1 E COUNTY. FLnR1nA: . .
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This b my dccl~rntion ot noniicile and Cittacnahip i~ tho St~to ot florida thet I Rm tiling tAis d~y in accordRnco. ~ad in ,
contormity with Sretion 7r2.17. Florida Steiutca. •
1 was form~~l • Ic~l rcaidcnt ei „~/,L~,~.d and I •
ICiV) 1 el
residcd ~t ~O1Q~v c/ c c~ .1~~i r~ . liowovcr. I h~vic eh~ngcd my domirilo to
. lStec~t snd Numb.r) '
• nd am and ?~avr bcct~ a bonx tidc residcnl o[ the Steto ot I~'lotid~ since ~ dar ot
~ ~9_7,~. ~nd I resido at ~a L ~ F.,,_,~ o A R~ ~ E •
~ ~ a.~' • ST. L.UG 1 E ro.~.~aH~~eea -
D ~ ~ ~ , . County. Florida.
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~nd this staicment is to be takcn es my decluration ot citizcnship. actuni ksal residcncc and domicile i~ the St~te o[ FloridA. ~
IP FOR YNE PURPOSE OP ENROI.LiNG .~F POR HONESYEAO PURPOSE5i
CNIL~REN IN SCIIOOL~ PLEIISE STA7E _ P(.EASE CHECK: ~
TNEIFt NAMESt . '
31~~29. . _
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I FUJtT)l~l~ CF.RTIFY tha~ I will regi~tcr at my local address wl~cn lhc rc~istr; tion boo{;s rcopen. and comply with all : ~
othcr rrquirc~nenls ot a lc~;al residcnt ot t~~is State. " '
I FUitT1iC; CCRTII'S' ihst I havc no intcntion to rr.turn to my formcr domicilc. and 1 intend to rcmain in ;i .
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