HomeMy WebLinkAbout0944 , /
' n of D m' il n itiz n hi ~
Declarat~o o~c e a d C ~ s p
~
~'32~12
TO THE CLERK OF THE CIRCUIT COURT.
~
t
ST. LUG 1 E Cp~tv'ry~ 1~"I,pRIDA: j
~
~
This is my decluation of Domieile and Citizenship in the State ot F'locida that I am C~tiag tAis day id accordaace, and in ~
eoatormity with Section 222.17. Florida Statutes.
I wu [o~`er~t~ a legal res~dent ot r K~ ,y ~ aad I
tCicrl Is~.c.) ~
residcd at _.~~~s_~ ~ 17 ~ . Awvever. I have ebsnged mr domieile to
( aod N~m ~tl
and am and have been a bona Gde re~ident ot the State ot Fbrida siaoe S~ dq ot
19 - aad I re~ide at ~~s~„~_S.ct •
, ~ (Stn~t ~ad Nemb~l
- ST . L UG 1 E Co,,,Acy. F?orid,,,
. ~ cav~
aad this statcment is to be taken u my declaniion o[ eitiunship, actusl kgai n~idenee and domicilr ia the State ot Florida.
• IP F'OR THE PURPOSE Of ENROLLING IF FOR HOMESTEAO PURPOSES~
CHIL~REN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THE IR NANES:
~3 ~ A~!LZ! I~ .~E- ~Y~ ~ L~ - .
~ 1~~~t
c ~ouN~r
?~t~,
a«RK sr.;~U;i c
u~tr ~
i RfCORO YER1?IFO.,~,~
~ • ~
_ ~ ~ i 9 0~ AH'?6 ~
32~2
I FURTIiER CERTIFY that I wil! register at my local address when the registration books reopen. and comply with aU
other requirements ot a legal resident of this Stale.
I FURTHEZ CERTIF'Y that I have no intention to return to my former domicile. and I intend to remain in
' $T , ~ U C 1 E ~ ~~~y~
ICit~l .
Florida. permanenti; .
: ,+1 •L`~~~%
,
~ _ .
~r ' ' : a} .
, ; ~t~
• ~i~.
• /
, r7 r
' ":'.,'~,~~C: _ - .
: , •
. . /,y ~ ~ C?~ . ~ ~ ~ . C- / _
C = L
~~''•~,~.l~~~....
~ ~-LrLlv~'
(Addrsa)
Sworn to and subscribed before me this % dsy o[ ~
t ~ . A.D.19?6 .
GER POI TR , CLERK OF C IRCUI T COl~2T .
ST. LIJG I E COUNTY, FLOR.1 UA
Btr : ~
EPUTY LERK ~ , 944
(nvt
~ ~ -
'~C e^^a fi r~,..ri>
~ ~,~+raa.'~as~~~~'~ ~ ~r - "~-.:F
_ =.a:~~-"~- J
. - .~a