HomeMy WebLinkAbout2388 . ~eclaration of Domicile and Citizensnip ~
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To~ci.ERxoF~c~xcurrcov~rr. 316955 ;
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, ST. lUC 1 E , ~pUNTY. F~,pRtDA: . ~
Thb is mp deelar~tba ot Domiclls sad Citisen~hIp in tbe State o[ t~'{o~ida tbat I am 61ia~ this da,~? io ~?ooo~dance. snd in ~
coatonnitr ~vith Seetioa 222.1~. Florida Statutes.
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I wu tormer a kgal resideat o~ ' ~ I
- lCW?1 18t~t+~1
~?sided d Roweves. I Aave c!u?nged aq? domicile to ;
l8t~wt a~d N ~ f
and am ~.3 bave beea a boaa fde restdent ot the State ot Flarida siace -~J ~
T1 ~ 4.19.~.. and I resids at p~~ 8 ~ J~ ~
(8hwt ~ Nw?bK)
_ ST. LUG 1 E ~„oc~.
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and this statemeat is to be takea ~a n~ deelaratioa d citiuaship. adual bgsl residenee and doa?ie~e jn the Ststa of Florida.
If FOR THE PURPOSE OF ENROItING If FOR NOMESTEAp PURPOSES~ ~
CHILOREN IN SCHOOL~ P~E/1SE STATE PIEASE CHECK: ~ ;
THEIR NAMES: `
cp p ~ t
- " i~~IUCAE COUNTY flA.
qOGit POITpAs
CIERK c,:'.CUIT COUIlt
AECORO vf~~rtEa
- S~ ~6 2 3z PH'75 ;
~ . ~ 316955
I FURTHER CERTIFY that 1~vill register st my local addres~ when the registratioa booka reopen. and comply with all
~ other requirements of a legal cesideat ot this State. ,
~ I FURTHE~ CERTIFY thst I have no intention to return to m former domic~e. aad 1 intead to remaia in
i • ~ ~T U C 1 E County.
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~ Florida. permanenu;
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~ ~Sir'oni~l8~"~~ ~subscribed before me thi~ day ot •!'l~.C/~.~'~C-
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~ . A.D.19 ~ ~ -
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ROGER P01 TRAS. CLERK OF C IRCUI T COUtT
ST. I.UG I E COUNTY, FLOR 1,UA
BYs
~ TY IERK
~ooK243 P~2388 ~
AGO Fornt 71 :2
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