HomeMy WebLinkAbout0736 ~?r~c~~ration ~ of f~~rr~icile and C~~~~~n~h~p
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TO TIIE CL~RK 0~ T1IE CIACUIT COUR1',
ST. Ll1C 1 E opvt~'i'r. F[.OatnA: . ~ " .
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This ls my dcciaration ot 1)omicilo and ClUzcn~hip ia the State ot Fforida that I am [~7in~ this da,~? in ~ceosdance. and tn .
eantormtty wi~h Section ~'2.17. t'lorida Statutca. ' ~ •
I was torm~rl a kgd reatdent of +?uud i
_ t ) IStatel d
~N] - - Howovcr. I v~ chsngcd my domic~'k to ~
and NomDK) . , `i"~ .
aad am and h~vo bcoa a bona !'ide rcaidca~ ot ihc Statc pt Fbrida since - day ot .
, l9~ ~nd 1 nside at
r~ • lStrwt ~ed Nntabetl '
f
i~ ~P~ ~_~I
~ C_~ F' ST . L UG I E County. Florida. .
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and this stutcment is to be taken ss my dectaration ot cilizenship. actual kg~l r~cstdeaec aad domieik in thc StuCc ot Fbrids.
IF POR THE PURPOSE OF ENROILIftG IF iOR HONESYEAD PURPOSES
~CHILOREN IN SCHOOL~ PLEASE STATE P~E11SE CHECKS ~ -
TNE R NAME 2
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fti.E~ AN3 ftECORDEO
~ ~ iT. LtiCtE CeiINTr f~A. ~ - .
aoz~2 Pat~us ~
~ c~.~Rx c;.~cuiT couaT
~ ~ RECOR~ vEM•FtEQ....~••~•
~ . ~ ~ 1i 2 ie PM'~6 .
~ ~ ~ 32334.'3 -
~ I FURT}1EIt CF:RTIFY that I will regisler at my local address when the registration boaks r~:.~.: r.. ~ casr.~ly with ali
f olhcr requircments ot a Icgal resident ot t!~is State.
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G
' I FUR :t CERTIF L~n
t I tiave no intrntion ta return to my former domicile. and I intcnd to rcmain in
s ~~1~'~~-+-IE--I~.C ~ ~ , $T,~ L
U_C~E , Cc~unly,
~ - (car? . . .
Florida. permanenti~.
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~ Sworn to ~twl~pl`i~~l~flf:,cl,t?~t~ro mo this ~
~ dny of • ~ ~ ~ :
~ .u =:;•'~~~_,•..1;-,~/j..., _~A.il.la_~~ 11
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t: i f''' ' _ ^ = ` - •
tt(~t~~(}I Xt211S OF C 1 RC U 1 T COU2T + - s
ST, ~ f<COUN~X;>a~I.OR 1 UA . ~ ` ;
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