HomeMy WebLinkAbout2432 - . ~ /
Declaration of pomicile and Citizenship ~
. 319p24 :
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TO THE Ci.ERK OF THE CIRCUIT COUAT. -
ST. LUC 1 E ~p~~y. ~,p~A: ~
Tbis is ~r declaration of DomIeile nnd Citiseaship in tl~e Scat~ oi F1orWa that I am tiUag this dqr in aecordanee. and ia
coatornaity with Settioa 222.17. Fb~ida Statutei. w~ ` . ` .
I was ~ormc a teaident qt~Y1.0~,( ~L 1~ / L L-S .L ~ r•('~! ~ aud I
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nstded a ~ Hawver. I bsve e6aag~ed my domicile to
(8trMt aad NrsbKl ~e
and am and h~ve beea a bona tide resident ot tlie Stat~e ot Fbrida siaas dU? ~
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~ T~ /1~ L= .19 and I reatds at • v - T ~ / ~
~ser..c..a Nume.r~ '
~1T Si ~U C I~ _ ST. LUC I E ~,o~,. ~;d,,
and this statemeat b to be takea as ~r deelantion ~ cittunship. aetual kgal reaidenee and domieib in t6s State ot Florids.
If fOR THE PURPOSE Oi' ENROLLING If POR HOMESTEAD PURPOSES~
CHiLDREN IN SCHOOI~ PIEASE STATE PLEASE CHEtK: ~ '
THE IR NAMESS ~
jitEir ~1: ~ ;
St.~,.:~,:~~r
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I FURTIIF.R CERTIFY that I will register at my loca! addresa w6en the regisiration books reopen. and eomplr with aU
~ other requirements ot a legal resideat ot this State.
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~ ~ FURTHE:~ RTIFY th I have ~no intrntion W return to my former domicile. and I intend to remain in
~ ~ T~ ~ E, L ~ $ T. L U C 1 E . County.
lCit~l
Florida. permanen~l;. '
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' (Nams)
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~ ti~ ~ .:i~?~`;'.- r , ;7 / / ~ ~ ` /
~ Swo~tltq~ied sttb~qiib~efore me this ~ day o~ ~l~ S~S~ •~%ft~ ~~V U T~C i¢ ~ t
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A.D.1~ 7.S ~~7~~JT--v~l~lt~~ ~~T~
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~ F~~~P1d~S
,_CLERK OF C IRCUI T GOURT s
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~ ST. L'UG 1 E COUNTY, F L.OR i UA ~
~ BY = '~c - ~ c. _ ~
EP Y IERK ~
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