HomeMy WebLinkAbout0192 , . -
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' i~eca~ratior~ o~ Da~n~cile and C~~izens~hip
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TO THE CGEAK OF TI~E C1RCUIT COURT.
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ST! LUG I E ~p~~y~ ~,pRIDA: ~
• Thts is my declsration ot Domlcile and Ciliunship in the State o~ F'io~ida th~?t I am tiUag this dq in ~ccordaace. ~nd in
eontormity witb Section 222.17. Florida Statut~s.
I w~s torn~+er1 a Icgal resident ot ~L~~r~~ ~ ~'~/L'~~SSAN and I
tav?~ is~.~
rssided at / /~y~d~'_ - Ho.vevee~ I have changed a~? domieile to
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aad am and h~ve bee~ a bona Cde tesideot oI the State a~ Florida sinee v v~E ~ S~ dar ot "
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. d~C ,19~6 , snd I nslds at Z~ GO~/OA t~~ . i
lStr«t~ndt~lt~a~etf -
~i= ST. LUG I E ~
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' aad tbis statemcnt b ta be takea as tay declaeation of~ citlun~hip. aetual legal reside~co and domiciie ia the State oi Fiorida. i.
I~ POR THE PURPOSE Oi EMROLLING IP fOR HOMESTEAO PURPOSES~
6NtLOREN IN SCHOOI~ PIEASE STAT~ PLEJI3E tHECK:
sHE1R MAMES:
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Ffe !T ~0 08 AM'7j
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I Fi1RTHER CEEt'fIFY that I w~i register at mv locnl addross ~rhen thc ngistration books reopen. and comply .vith al!
othe~ tequiremenb ot a legal resident at this State.
I FUBT E;t CERTIFY t st I have no intration to return to my tormer domieik. and I iatend to rcen:ia in
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A~SC A~ ~tAGiY - ~ ST . L UC 1 E ~~uA~y
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F~ (Cit~) . .
Flatlda. permanenci~ .
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Sworn to and s•rbacribed bcfore me this day of ~ 5~,
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' - A.D.19 7~rJ
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R GQ ER PQ~TRAS. CIEFtK OF C IRCUI T COIXtT
~ ST. LUC. i E COUNTY, FI.OR t UA • ~
BY: ~ • ;
EP Y LCRK
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