HomeMy WebLinkAbout0035 . 1 r tion of Domicii~ and Citiz~nshi _
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TO THE Ci.EltK OP THE CIIiCUIT C~UAT. .
ST_ lUC I. E ~ ,~OOtJM'Y. ~'[.OR1Dl~ . . .
7'Mh b m~? deeluation oI Domicile sud Cittueahip itt tbs State o~ 1~
locid~ tb~t I am t~ tAis dy? ia seeocdance. aal la
~oofan~l,y witA Seetioi Z2Z.17. Flotid~ &atnta. ~ .
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Z waa y~ a e+~sideat at ' aad I
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t~aided at ? ~iowsva~.1 Aaw eb~a~ed aq? domiciM to: -
fatn~t~N~reK! . -
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aad and baw beeo a boaa lfde resid~nt at tbe StaL~ olFlorida sieos ~f ~
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- sad I nside at °7
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~ $T• ~ ~ Couat~, ~7orids. .
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illd ~~tlWQII~ ~3 ZO ~~ell a! 1~ dlt~Ti~OA Ot !~tlAlll~. aotnal kgal residenee and domieik bs the State ot Fiorids.
If FOR THE ~URPOSE OP ENROLEING , IP fOR HOMESTEAD PURPOSESi
-CH II.~REN t N SCH001.~ PI.EASE sTATE PLEASE CHECK: ~
THEIR NIIMESS -
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~ - _ `~tllEO ~tIQ RE~OR~~
~ . ~ ~tit H~~TAAS ~
~ tlE Ci CUIT COY~T
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1 FURTHER CERTiFY that I w~U register at mr local address w6en tbe registrat+on books nopon. aod eomptp witb dl t
i otber reqnireateaLs oi a kgal resident ~ t6is State.
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~ I CE I~bsve ao intention to return to m torarer domic'k. aad I~?tead to rera~in . in -
- e.Jt~ R~8~.c,cJ1.c~ ._~r . L u c ~ e . County.
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Sw to aed subscrtbed betore me tbi~ ~ dsr ot a 3 3
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A.D.19~ 7
~ A C ERK OF' G iRCU1 T COU2T
sT. ~uG 1 E couNr~r, f~oR ~ oa ~ -
~ BY: - ~ s , ~ ~
. ; E Y LERK ~ ~ .
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