HomeMy WebLinkAbout0750 Declaration of Domicile and Citizenship ~
TO TKE CLERK OF THE CIEtCU1T COUAT. ~
_ ST. LuC I E OOVtv~1'r. FtA~n~:
Tbb b aq? dedaratioa ot Domicik a~d Citisea~hip in ths State ot Fbsida tbat I am 81in~ thi~ day io soooe~daaos. and ia
coafacm~t~ ~vitb Section 222.1T. Florida Statutes. . _
• I was t
r~erl • iegal resideot ot j ~ ~/e _ j• l~~lbl~ I... -
IQVI I~
r~ded u=~/~'~~ J.r F no A n Ho~revar. Y havs ehan~d nU? dom~ ~ -
(8t~~+~t ~d N~~) ~ .
•nd am sad bave been a boos Rde nsident ot the state ot Fbrida sinee /'~/Q 1 L dap ot
19~~iod I reaide at 7 ~ ~ ~ ~ ~ '
(8tew. ~ed N~l
~o~ C` f~' C,L _ ST. LUG I E counc~.I~'lor~da.
tavl
aad this atatemeat ts to be taken as uq deeLntioa ot dtisen~htp. +ctual legal rasideace and domieile ia the State at Fbrida.
If fOR THE PURPOSE Oi ENROLLING ~i fOR HOMESTEAD PURPOSES
CHIL~REN IN SCHOOL~ PIEASE STATE r~EASE CHECK:
THEIR NAMES2
fIIEU :.r~pa~EO
, ST l'JC~: s:;MIY F~A.
„F~ lE'~. .:;t_~?R UA~~
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OEC I 10 Z1 A~'15
I FURTHER CERTIFY that I will register at my locil sddresa whea tlie registntion books reopen. aad comply with aU
other requirements of a legal resident of t6is State.
~ I FURTHER CERTIFY t1~t I have no intention to rttwn to my former domicile. and I intead to remsin ia
E • , ST . L U G i E _ County.
~ ((St~1 . ~ _ ~ -
~ Florida. permanenti; . -
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; ~ . . (Nam~)
~ t~r~ ~ ~ GO
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~ Sworn to and subscribed before me this day d
; C; c j'~7 . A.D.19 75 '
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~ ROGER POITRAS. CLERK OF C_IRCUIT COl~2T
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~ ST. LJGIE COUNTY, FLORiUA ~
~ 8Y: ~ ,
~ uTY ~EaK
~ v ~ BOGK PA -
~ S ~E ~ 749
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AGO Form T1 22
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