HomeMy WebLinkAbout0152 . ~
~ Declaration of Domici~~ an~ Ci#izenship ~ `
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TO THE CLERK OF THE CIRCUlT COURT.
ST. LUG I E ~~0
. COUNTY, FL4ItIDA:
TWs b a~r deetaration ot Domicils aud Citir+eaship ta ths Sb?te ot l~'brid~ thst I un fitina tbis dyr ia aooord~nce. and ia
~os[onniyr witi~ ~eetion ci'2.17. F`joriaa ~ia~aies.
I ~ras t rmc a kgal re~fdeat ot ~b ~ j; - _ ~n L ~ ~ _t~' ~ , ~ I ~
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reaided at ••QC~ ~ ~ - o. R-~ ~ Hoaever. i 6ave elua8sd ~y domecile ~o
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aad am aad have beea a boaa tide resWeat ott~e State ot Florida sinee v. 3 O
~l~~S... asd i reside at ~-t. ~ o x 3 9 c~
~ i p t~ ~ Q,~_ ~ ST. LUG 1 Est~wc~N..e.~~ ~t . Florida.
tC1y1 r
aad tl~s atatementb to be talcea as m~ dedaratioa ot c~tiunsl~ip. adud kgal resideaee and dooatdle ja the State of b'lorida.
If POR TNE PURPOSE OF ENRO~LiNG IP POR HONESTEAt1-PURPOSES~ -
CHILOREN IN SCNOOL~ PLEASE STAtE PI.EASE CHECK: ~
THEIR NAMESS
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RR ~R~~y OOYRT
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I FUA7'HEA CF.ATIFY that I ~n'll regiater at m~ local address wben tbe registsatioa books reoNcn. ~nd eomplp with aU
otber tequiremeats of a kgal resident oi tAis State.
I~RTHEZ CER1'IF'Y that 1 bave ao inteation to retura to my tormer dom;eDe. sad I iatedd to nmain ia
~.i. ~ ~v ~+L` ST . l. U C 1 E . Countr.
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Fbrida. permaneaci; . ~ ,
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Sworn to and subser~ibed betore me this ~ day ot _ _ ~ .~i ~ n~_~.~____
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: ; ,~.e.~s.? A.D.19_ 7G _ .
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. j~~__;____`~0~lr~R~ _IYS",,~-~,~~ERK OF C i RCU 1 T GOt~ T ~
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