HomeMy WebLinkAbout0282 Declarati~n of DorniciEe and Citizenship u~
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TO TI i~ C1.ERK 0~ TllE C1RCUIT COURT.
ST. LUC 1 E cou[vr~r, ~.ottt~~:
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TAb Is my deelarataa of [)omicik and Citiuas~ip in tM Stat~ o( F{otid~ tb~l 1 am Win~ tAis dq ia aeeotdanc~. apd ia
e~farmitr ~ritA Section 2'L.17~ ~iwid~ Stat~t~s.
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1~ru (o~~ a kssl nside~t ot ' • Lr~~~l ~L( ( aad 1
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hiided at , 1~V ~ ~`t r7 ( 17~~_ ~O Ho~wwr. l baw ehaesed n~y domieik to
{Ote~t ay N~~?rl ~
~ad aud bavs bcea ~ bona fid+ ~e~ideat ot tM Stat~ of Fia~ida siae~ dap ol
».1~.aa ~ n~a..e 1 /l ~ e'~~'~ ~-t~'~
~ Ist+wt a~ N~MrI
ST . L UG 1 E CouAty. E~orida,
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ud this st~temeat it to ee taken as m~ detlar~tia+ ot cituensAip, actua! k6a! re~sidenee and do~aicile in tM State ot F{orida.
I~ F9R THC PURPQSE Oi ENROIIiNG I~ fOR NOMESTEA~ PUR'OS[S~
CHII~REN iN SCHOOI~ PL[AS[ STAtE ?l[AS[ CMECK: ~
TH[IR NAMES:
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tIlEO ~wo ~ECwy~~
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t~ f K[ C,:('.~~T -w~
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Arc 13 8 so ~!I '16
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; i F U1zTilER CERTfF'Y tlut ! w~ll rc~~tcr at my kxat address when the re~strai~oa book~ reopcn, and complr wit~ ~ll
otber requirem~nts o( a 4•y;sl re~idcnt af tA~s State.
PUI~TIlF'Z CE:fi {!'Y tlut 1 Ravr no int~-ntion to rcturn to my (ortnrr dom~c~k, and 1 intend to rcmaen ie
-T..~_T~ - - L~~! j,t~ . ~ ciTi.~ U~ [ - - Counly.
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_ FtnC~'~R i'O1TR _,_._Cl^ERK_OF C IRCUI T C4URT ~
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