HomeMy WebLinkAbout0330 . . . . . . yr /
. D~ciarat~on of Dor~n~c~1e and C~t~zer~shfp
~ 33 c2
: ~7
TO TfiE CI.E~tK OF TNE CIRCUIT COURT.
sr. ~uc ~ e oour~r~r, FLORIDA:
This b mp decluation ot Domicib aad Gtitiaeaship ia the SLsta o[ Fbrida that I am Ning this s~y? ia acoordanos. snd ia
tonlortnicy with Seclion 222.17. b7orida Statutes. ~
I wa.+ to~ a kgal resident oI //~d~ and i ~
1 ISut+)
resided at .~,ad~llr,4 - Ho~rever, I bave el~anged aey dom~eib to
t aad N~sOK) .
aud am and lu~ve been a boaa C~de resideat oi tbe 3tata o[ Florida sinee ~ • da~r os -
- '-19~~. ~nd I raside at 7/~a~ ~ p~ aL Ct~,c~ •
. (8tre.~ aod Num~)
~ ST . l l1G 1 E conpcr. Florida,
cavl -
aad this slatement ta to be takcn aa mr declantion oi citiuashlp. actuat kgal naideAOe and domieiie in tha State of Florids.
IP FOR THE PURPOSE OF ENROLLING IP FOR HOMESTEAp PURPOSES~
CHILOREN IN SCHOOL~ P~EASE STATE PLEASE CHECK. , ~
7HElR MAMES: . -
. - ;
~T LU~~ ~ ~OUNTr ?lA
ItO~f ~ P•)+!R~~
_ CLERt ;;,;1iT ~QURT ~
pE~G%:, Y•' ~ ~t_'~
. An~ 13 12 ~9 °N'76
- 332;2'7'7
I Ft1RTHER CERTIFY that I witl tegister at my local address when the registratioa booka reopen. and oomply with all
other requirements ot a legal resident of this State.
I FURTHE~ CEA 1' t6at have ~o intention to retc:
n to my former domica7e. aad I intend to remain in
' ~.tl .~'J p-i ~ ST . L U C 1 E - - . Connty.
~ (Cit~) . _
~ Fbrida. permanentl; .
i ~
~ ~ .
~
- -
:=~G.~~ ^ s
~ . _ ~~'fi~,_ . _ -
t l~
_ • _
'
~i
.
~ ~ ~•'~,'~'r' 'g0-~' lwms)
~ • • (Addeess} -
~ SM orn to and suhscribed belore me this day of -
~ .
~ A.D.1J 7G
~ ROGE PO i TRAS„ CLERK OF C iRCUI T COURT ~
ST. LU(: i~ COUNTY, f LOR 1 vA
Bv: ~ .
~ ~~rY LERK ~=~251 rA~ 3~9
:
? ~
~
~ _
r~,-~, ; ; f
- =s ~
~z; ~
a
~ "s