HomeMy WebLinkAbout0393 Dectaration of pomicile and Citizenship
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~ror~ cc.~~uc oF~ c~currvouRr.
ST. lUG 1 E ap~y. ~,p~~;
T6is b m~ deetuation ot Domie~7e aud Citixewbip ia tbe Stat~ ot F{orida tliat I am hlina t!w dar in aceord~aee. and in
~oatoraaitr ~ritb Sc~ction 222.iT. F7o~da Statutsa.
I ~ras ~Y s kaal resideat ot ~/.f'-~~~ ~ , • and I
, {py1 istatd
resided at - Hoaever. l have cDanged mr domicile to
Istn~t W N+~M~I
aad aw aod ltave been a bona Lde resideot o[ t6e Stnte o[ Florida aince ~Q ~ day ot
`~~~v ~ 19~aad I e+eside at ~ ~ ~ ~ ~ ^ , ~
• 1&rMt ~d N~l
~ T~,~.~L- , ST. LUG i E `
Couatr. Florida.
taai '
and thia ststemeat is to be takeo as m~ deeliration ot ritizeoahjp. aetual l~gal resideoee atid domie~e in the State ot Fbrida.
IP fOR THE PURPOSE Of ENROL4ING IF i0R HOMESTE/1~ PURPOSES~
CHIIOREN IN SCNOOL~ P~EASE STATE P~EASE CHECK: ~
THEIR NAME52
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I/,~U •
' . . fILED iH0 RECORQEL `
r~~ ~ iT. lllClE COUNT~ frA
~ ROCER POITqAS
CIERII CIRCUIT COURT
RECORO YERiFiEO
- JaN 1~ IZ s2 P~!'~1
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~ I FURTNER CERTIFY tlut I w~l register at m~ bca! sddre~ w6en the registntion books nopen. and compl~ .vith ~ll -
li other ~+equiremeats ot a{ega! resident ot this Stzte.
~
~ I F[1RT'HE~ CESTIFY t6st I luve no inteatiou to return to mp [ocmer domiale. and I iatend to remain in
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` _ - S T. L u c ~ E . County.
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! Fbrida, permanenci, .
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sw~ c~.~a ~,~-~a eer~ ~ tn~ a., ~r T
G~'~~~ ~,c.c.c~ _~~s• .
A.D.19~7 3~7 7' Sy
ROG P01 TRAS LERK OF C IRCU{ T COl~2T
ST. LiJG1E GOUNTY, FLORIOA -
e,r: uC~~!~ ~ •
TY IERK -
BL~K~u3 PAGE 378
ACO Form Tt 22 `