HomeMy WebLinkAbout1728 Declaration of Domicile and Citizens~ip ~
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TO THE CI.BRK OF THE CIRCUIT COUAT.
ST. LUG 1 E ppU~'1'Y. FI,pRIDA:
This b aqr deciaration ot Doaaicils aad Citi~enship Ia tbe 8tat~ ot Fforida tbat I am liliaa tAis dy? Ia actoe~danos. aad ia
ooaforaaitr with Section 222.1T. F'lorida 8tatutM. ~
I wu t erl a legal caideAt ot ~~.1.L1 F { 1,~ T~~ ~ , t and I
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resided aL - , How
~sr. I bsw elu~aged ay? doaaiei3s t+o
(8t+wt a~d Na~lKl ~ -Cl\
and am and bave been a booa fide resident ot tAe State ot Fbrida aida dqr ot ~
~r r a • • ~ r h ~ / t l ~1) e' ~9 1 E ! ! ~
,O~-I~j c~v~ ~~-~r _i~..:L~...~,ai~a.u ~,ld,~~~,~,~ SI~DE ~3L V~, ,
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and tbis statameat ia to be takeu as apr deelsntion d eitiseasi?ip. aetual k~sl resideaa aad donJcils tn the State a~ Flarida.
IF FOR THE PURPOSE OF ENR4LLING IF iOR HOMESTEAD PURPOSES~
CHILDREN IN SCNOOL~ P~EASE STATE P~EASE CHECK: ~~j
tHE 1 R NAMES: ~ ~
f1LED ~NO RE
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I FtJRTHEB CEItTIFY that I~l register at my local address when the regisiration books reopen. and eompiy with all
other requirements of a kgal resident oi this State.
I FU CERTIFY thst I have no iatention to return to my torn~er. domiG'k. and I intead to nmain in
~0 /~i T. S T. ~ 1 C~ / _ $T . L U C 1 E~ , County.
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Fbrida. permanensi; . IL,~ p ~ ` . _ ~ -
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Swortt.~iw~a.f .''bed beloro me this day of -
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- A.D.19 /
ROGER P01 T'F2AS, CLERK OF C IRCUI T COU2T
ST. LUG i E COUNTY, FI.OR t DA ~
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_ • AGb Form 71 22 t
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