HomeMy WebLinkAbout2174 Declaration of Domicile and Citizensnip ~
~ 316'798
TO THE CLEBK OF THE CIRCUIT COURT~
ST. LUC 1 E ap~~. ~,p~pA:
This is aq? dectaratioa at Domkile and Citirenship in ths State of Florlda thsL I sm tlliaa tlds d+pr ia aoeoe~daacs. and ia
aoniormtty w?tch seccjoa 222.17, Floriaa stacut~s. ~
I was to~ a kgal res~deat ot -~.~/~'l~?G f/~+L ,/~'1 / S S o~/~ ~d I
lC1yf i&at+i
teai~d st _~v~ ~i/D .~-1~.~T f-' - However. I have et~anged nq? dowicik to
t:'+:.
~ ~ad N~? ~
and am aad have been a bona fide resideat ol the 3tate ot Florida siaa ~ dq? ot
_,_:19 7S - and I reside at -IS9L ,E L~'`?' h~v~,ST
(BtrNt.sd tZnmbr)
_ .Sv~~.~-~i Pv,c~ .~T. L u~~ •e , ST. LUG i E Ca,nt~. Fbr~d..
and this statemeat is to be takep ss np? declarataa oi eitisenahi~. aetual kgal residence and doa~idle in the 3tate ot Florida.
If FOR THE PURPOSE OP ENROLLING Ii fOR HOMESTEAD PURPOSES~
C1i1LOREN IN SCHOOI~ PLEASE STATE P~EASE CHECK: ~
THEIR_NAMES:
c~S~A.r~N~l n ~a i,CSr,~i~ ~ -
~L~ ~ 1.a r L. r.f~~r. L.?.92D
flLfD.ihQ AECORDE~
' . ST.lUC1E C~UNTY FtA. ~
ROC£+~: P'~~'~~AS ~
CLf~tK C~,~JIT CCURT
RECnpT ~
- ~ S~r 15 ~0 3i AM'75 -
~ ~ 315'798 `
r
i v'RTHER CERTIFY that I w~l regiater at my 1oca1 address when the registration books reopen, and comply witA all
ather requirements of s 1cga1 resident of this State.
~
t
I FURT~E~ CERTIFY thut I have no inteation to return to my former domicile, aad I intend to remain in i
_ ~~d~J~ .~T L G/ L/,e S T. L v t 1 E County, ~
(Gl)1 . ~
,
Florida. permanemi; . '
.
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c~aaro..~
Sworn to and subscribed before me lhis ~ s~ dey oi ~ ~~/1 T__~_1 v` i-e
A.D.19 7~~ '
ROGER P01 TRAS, CLERK OF C IRCUI T COU2T
ST. LIJC ! E COUNTY, FIOR 1 U ,
BY:
s
EPU7Y ~ERK ;
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' soox243 PaGE~17'4 ~ ~
AGO F'arm 71-22
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