HomeMy WebLinkAbout0977 I r ti~n ~f Domicile and Citiz~ns~i
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TO TNE CI.E1tK OF THE C1RCUIT COURT. - ~
ST. LUC 1 E COVNTY. FtARmA: ;
T6is is my decluation o! Domkik aad Citi~oaship in the Stats ot Florjda that I am tiliag thts dyr ia aecocds~ee. and in
confocadty with Sectioa 222.17. Fbrida Statutos.
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I~r~s tormerl a kgal residepl ot ~
lQicyl (Sual
it ~ However, I bavs ehanged my domieile io
(8teMt a~d NusbK) •
and am and have beea a boaa C~de re~idept ot the S~ate ot Florida sinoe dU? ~
- '-19_~ aud I reaide d ~ ~ ~ ~ . .
- (8h+~t ~od Nwnb~l
- ~ . ST . l UC 1 E Conncr. Ftorid..
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~ ZIltS SLattdlCAL !S t0 bC WfOA il nly det~iTiUOp OI tj~iZCQSIIIp. actual legal cesideacs and domicib iu tbe State ot Florida.
Ii FOR TNE PURPOSE OF ENROLLING ~ IF POR HOMESTEAp PURPOSES~
CN 1 LDREN 1 N SC~100l.~ PLEASE STATE PLEASE CHECK: ~
THEtR NAMESt _
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FIifD R\:~ ~",.ROfD
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I FURTHER CERTIFY that I will register at my loc.al address when the registration books reopen. u!d eomply ~rith all
~ other reqairements of a legat resident oi fhis State. .
I FUftTHEB CERTIFY that I have no intention to return to my former domscile. and I iateod to remain in
~
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Florida. perruanemi;. ~
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5w osri ~'e?And ~ul?scribed ture me this ~ day oi !P ~ i ~ ~ •
. ~ ,
. A.D.19 76
ROGER ~ I TRAS, GLER~C OF G IRCUI T COU2T ~
ST. LUI; I E COUNTY, FL 1UA
BY: ~ ~ x
/ PUTY LERK
, ~ E r 1 ~51 PAGE ~7~ ~
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