HomeMy WebLinkAbout0209 Dectaration of Domicile ar~d Citizenship
~
~ 35986~
TO THE CI.ERK OF THE CIRCUIT WUAT. -
ST. LtJG 1 E pp~y. ~,p~pA:
This ts mr d~etarsejoa ot Domteils and Ctct~earhtp in che Stse~ ot Florida tbat i am tWn~ thts dy? b aooord.ao~. ud ia
contocmity ~ftA 3~ctioa 222.1~. Florida 3tatutM.
t~
J • F
I was t~ s leaal resident of - . ~od I
~ ~c+U~ ta
wsided at ~ e~ - Hmr~v~r. I hsw ebsaaed a~,p doada'M W
. (Sen~t ~d N.~Mri
aad am u~d hav~ bMn s boaa.fid~ e~sideat o~ tbe 3tat~ otFb~{da sina da~ ct
. 2~~. and I t+pid~ at ~D 0~~~yT,vL1f ~~`~1
• l~Mt a~d N~b~l .
ST. LUG I E ~t~.
~cw?
and this statement is to be takea as aU deetantion ot dtf~eashIp. aetual k~al re~ideac~ and don~ieilt ia ths State ot Floeida.
Ii fOR TiiE PURPOSE OF ENROLLIMG Ii iOR HOMESTEAO PURPOSES~
CHILOREN IN SCMOOI~ PLEASE STATE 'LEASE CHECK: ~
THEIR NAMESS ~
~ ~ iT A06 E CO~tr ~f0
RE ORO K~R U
T
~~S t~t.
~ERri?EO ~~Rt
~ ' , ~ , M4R ~ ~
~ ~
~ so Ay ~t r
359961 -
I FUB'fHER CERTIFY that I aill register at mr Ioca! address ~rhen the registntion books reopen. and ooenptr ~vita afl
other :equirements of a legd resident o[ t6u State.
I FUItTHEZ BTIFY tiut I have ao intentioa to return to m~ lornxr domicik, and 1 jntsad to remain in
$T . U C 1 E Connty.
i_~ l(:it~l .
Florida. permanenti; .
' f•
I : - ~ ~
. ~ .
• ' INaaw)
~o o a'- ~ir~ ~f
~~aa:...,
Sworn to and subscribed betore me this day of .~i~tiSR~C_•
. A.D.19J7 _
ROGER POITRASi CLERK OF ClRCUIT COt~2T
ST. LUG I E COUNTY, FL.OR 1 UA
BY: _ ?
EPUTY IERK
~ Q[~1 ~ PA6E ~UO
AGO Form ~1 22