HomeMy WebLinkAbout0689 Deciaration of Domicile and Citizenship ;
34U5~H
TO THE CI.ERK OF THE CIRCil1T (:OURT.
ST. L l1G 1 E ~;p~y. ~,p~pA:
Zbb~ b asy declaratioa ot Domieile and Citiua~lup in the SLate ot F7ocida tlut I ua fitina tl~is dp ia toootdance. and in
eoatocmity ~rith Seetio~ 222.17~ Florida Statutes. ~
r I wss ~ a kgal resideat ot ;
~ e wF_ ~ /'4~~"~-~ ,~/9 .sS/~~/S+~ti SCTi~~ I .
. IQUr) 1&atd ~
resided at ~Za T~ Y E - How?svet. I bave ehanged m,~r domieile to
(8v+~t ~.d Hr.lK? ~
snd un and have been a boaa Gde resident of the State ot Fbrida sinoe dar o[
~r r'~ Q E.LQ .19~~ and I nside at ,~o ~~~.~?Ay f~e ~C.P /P~
(&erK ud N~bu)
FT Pir'~! F ST. LUG I E ~ty. ~
.
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and tlus statement is to be takea aa my declaniion ot eititen~hip. aetuat kgat residenae and domie~7e ia tbe State ot Fbrida.
IF POR THE PURPOSE Of ENROLLING IP fOR HOMESTEAC PURPOSES~
CHILOREN IN SCHOOI~ P~EASE STATE PLEASE CHECKt ~
THEIR NAMESS
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i~lf~ t4. ~ECQR~O
WCai : Oi1NTY l~,
fi~~t = 'il!'RAS
CiEFx 4-- .Ult COURT y^~~ t
QE^~ys•- .:F~.~~~~.~~:~
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~uc 2b IO 56 AN'~6
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I FUR1`HER CER'I7FY t6at I w~71 ngister st my local address whea the registratioa b~ooks reopen, and tompl~ with all
otl~er requirements ot a legal resident of this State.
I FURTHE~ ERTIFY thtt I have ao intention to retum to my former domicile. and I intead to .remain in
F~ i L'` ~ G/= ' ~ S T. L U C 1 E Connty~
(at~) .
Fbrida, permanenti; .
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. L ~ r i~ 1^•' ~~"1:' ~
tNamel
. . (Addr~a)
Sv?orn to and subscribed betore me this ~ r`- day of
_ , 1 - A.D.19 ~ 6 ,
. ~ . 7 .
- ROGER P017RAS, CLERK OF C IRCU I T~fl1~
,
ST. LUG I E COUNTY, F LOR t DA • - J:°~
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BY: `_y r;. . _~i;.?'.~i?~•-i - ,
E P Y L E R K / i'••
. , S~ . e~
t ~r 2~ ~ f
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