HomeMy WebLinkAbout0655 , , ~ . . . . • 334f~19
Declarat~~n of ~om~c~ie and ~it~zensh~p ~
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TO THE CI.EBK OF THE CIRCIJIT COURT,
ST. LUG 1 E pputv~r~t, Ft,onm~:
Tfiis is mr declsration o[ Domicile and CitiuosAip in tbe State ol F`lorida lbal I~un filtag this dU In aooocdanee. and ia
coatormity arlt6 Saction 222.1?, F'brida Statutes.
I was to~ a 1ega1 resident ot - ~ I
1Ck71 ~
resided at Ho~rever~bave cbanged my domic~e to
(SerMt a~d Nos~) ~E.
and an~ and have beea s bona fide at ot t6e State oi Florida sinee d+~J? ~
' 19~ aad I reside at ~,.f/- ' •~•s = i _ ~~T
l&~ a~t t~.~l -
ST. LUG I E co~ntr.
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aad this statement is b be takea as mr deel~ntion oi e~tiseasldp. actual kgal residence and domkik in tM State oi F{orids.
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li iOR THE PURPOSE Of ENROLLING If POR HOMESTEA~ PURPOSES~
CHIIDREN IN SCHOOL~ PIEASE STATE P~EASE CHECK. ~
THEIR NAMESi -
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~ - 334~~ ~
F~~EO ~Ecu~o~o
ST. lU~i; ~11iTY FLA.
f- ii:i - 'i . =A$
• G[E~ ~ ' ;,:si' :CURT
_ A:^~-. yf-;t:~i~.~.~~
_ Mar I I i 36 PN'T6
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i I FURTHER CERTIFY that J w~71 register at my local address ~rhen the registration books reopen. and oompl~ ~rith all
other requirements of a kgal resident oi this State. .
I ~ ERTI that have, ao intention to nturn to my fornier domicile. snd I intend to remsin in
S T. L u c ~ E , Connty.
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Fbrida. permanenci; .
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n . ~ • . '~~7' ~~f.~ Y i~... W rr~ ~
~ ` , , • - ` - o / i I7~. l~..ri
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. 5worn tb aqd s,ubBetu"bed betore me this ~ day of '
( ' ~ , . A.D.19 7 6 ~i~%r'i`~s,ti ~.S`,Z,
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ROGER PO AS CLERK OF C IRCUI T COURT A r 1/~ ~ ~p ~ I
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ST. LUG I E COUN N, F L O R t 0
A v~ Il
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BY: ~I ~ ~ ~ s;~-
EPUTY LER
Y P
Y 9~7 . c?cr