HomeMy WebLinkAbout1966 claration of Domicile and Citizenship
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Tp THE CLERR OF THE CIItCU1T t~OURT. .
ST. lUC 1 E OOtJN1'Y. Fi~OAIDA: '
This b m~ daelaratba ot Doaakik and CitissnsAiP io tb~ State ot Fbtida tbat I am ti~ai t~s da,~ i~ aeooed~sos. ai?d in
eootornaitr .~tb seectou 222.~Z. Fiorja. sc.tut... .
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~ 7' /.S! -~lv~N /o k'ER3 B~ D~-' How~v~r. I bavs cbanpd u~? doaaie~e to
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and am and Lave beea a boas fd~ resident ot the 8late ot Fbrtda sinee
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and this ststiwent is to be takea as m~? deciaratioa ot dtiunshiP. utwl legal r~ide~ ar~d daokib in t6s 3tste d Floeid~.
If fOR THE PURPOSE Of ENROLLING IP fOR HOMESTEAO PURPOSES~
CNILDREN IN SCHOOI~ PIEASE STATE PLEASE CHECK: ~
TNEIR NAMESS . -
~o G~f~i,~ DRENS
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~ I p'URTHER CERTIFY that I w~i ngister at mr local address ~rhen ti~e registration boofcs reopen. aad comPh? writb all
otber requirements d a legal nsident of tbis State.
F'UATHER CEATIF'Y tlut I have no intention to nturn to aq? former dmnieile. and I intead to remain in
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Sworn to and ~ubscribed before me this ___1 ~ dsY ~ ' Y
~(~/P h______-: A.D.19 ~ ~ -
ROGER POI TRAS. C~ERK OF C 1RGU1 T COUtT
ST. LUG i E COUNTY, f ~OR 1 UA
BYs 0 R ~~5 PACE1~~
UTY LERK ' BOOK
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