HomeMy WebLinkAbout0778 ~t~ectara~ion o~ ~omicil~ ar~d Ci~iz~~ship
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TO TNE CI.BRK OF TNE CIRCUIT COURT.
ST. L UG 1 E (`pUN'!'y, FLORIDA: .
Thb b my deetuation ot Domicik aad CiE~cnehip iu L6e State ot Florid~ that I am filiag thi~ day ia ~ecotriance. and in
~onfaa~ity with Sectioa 222.11. Florida Statute~.
I aai tormcrl a kgat e~estdeat ot ~Oif ~6V st ~~Q ~ , ~~1~ ~i+'t~ and I .
+ n f tCKr1 Isuaf
n~ u ~ S/lv~ ue l.:i ~tle .~~owever, I havic ehingcd mr domieile to
f8t+.~t aad NumE~f •
tad am and have been a bona t~de resident ot tbe State ot Florida since d~r ot
Na ve.~ ~Ct, ~ 19_,LL.~ aad I nside a! ~ 70 ll rA r~ a. Ave ~ wc..
1seh.e worrer,
PB k ti e _ ST~. LUC t E County. florida,
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and thLi statement ts to be taken as my deelaration oi citjrensbip. actual kgal residenee and domicik in ihe Stato ot Florids.
If POit THE PURPOSE Of ENROILING IF fOR HOMESTEAO PURPOSES ~
CNI~~REN IN SCHOOI~ PLEASE STATE PLEASE CHECK: ~
THEIR NAMES: _
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ST
UCIE COUNTr f~A.
• CLE KCCIRCUIT COURT
RECOR, YERIFIED
~Ak Z~ 4 21 -
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I FURTNER CERTIFY that I will register at my local addre~s when the tegistration boolcs reopen. and eomplr rvith all
ot6es requirements of a legai resident ot tbis State. -
1 F'UKTHE~~BRTIF'Y that I have ao intentan to nturn to my former domicile, and I iotend to remain in
orf ~.kciQ y ST. LUC1E ,County, i;
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Florida. permanemi; .
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SMOrn to iind subscribcd before mo this 22nd dsy o{ r .~u [ i~, F~ o r~~c~. 33 `f J
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~ December A.D.19 76 -
MARGIE L. HUDSON, NOTARY PUBLIC. !~ty commission expires September 6, 1980.
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_ :~IONTGO2IERY CO[lNTY ALABA.~IA , ~ .
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Nota Public ~
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