HomeMy WebLinkAbout0249 Declaration of Domicile and Citizenshi r
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TO TNE CLERK OF' THE CIRCUIT COUltT.
ST. LUC 1 E ~pUM'y. ~t,ptupA:
TAIs L ap? declaratioa ot Domicile and Cit~eaship ta the State ot b'lorida tlut I aa~ Cdtag tAts dap ta aeoocdsncs. and in
coafoe~alty with Section 2?'1.17, Fbrida Statute~.
• I~ras to~ a legal e~asideat o[ ~
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, lClt71 letat~!
resided at Rwnever. I have changed my doaucile to
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aud am and h~ve been a booa Gde resideat ot the State ot Fbrida sinos ,~7 day ot
~ tJ~1t~ Z=Jp ~ 1~ and I e~eside at 1.~f_~s ~~•r7_
~ ST. LUG i E~~N~~
i ~ CIpL~~'-' , Councr. F7orida.
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aad this ststemeat is to be takea as mp declaration ot eitiunslup. aetual legal reaidenee and domieile in the State o[ Florida.
IF FOR THE PURPOSE Of ENROLLlNG If FOR HOMESTEAO PURPOSES~
CHILOREN IN SCHOOI~ PIEASE STATE PlEASE CHECKS
THEIR NAMESS ~ ;
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I FURTHEB CERTIFY that I will register at my local address when the registntioa books reopea, and comply with sU ~
other requirements ot a, legal resideat of tbis State.
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' I FURTHEZ RTIFY t I have no intention to return to my formet domicile. and I iatend W remain in f
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' Florida. permanemi; . - -
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; S~?eYh.W apd ~u6~ttiped before me thu day ot 1~ ~ILG ~ t,~
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~ ROGER ~ P01 TFtAS,~ CLERK OF C I RCU I T COl~2T ,
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ST. LL~GIE COUNTY, FLORiDA '
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~ AGO Form 71 ~
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