HomeMy WebLinkAbout0876 Declaratiara of Dor~iGil~ and Citizenshi~
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TO TH~ CLERK OF THE CIiiCU1T OOURT.
ST. L l1G 1 E apv~y. ~,,p~p~,:
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~ T1~b V mp deelaratba o~ Domkile aad C~tiun~Aip ia tM Stats ot Fbrida tMt I am t~ tRV da~r ia ~oooed~ace. as~d ta •
eotJormity ~ritb Sectioa 222.1Z. Fbrlda Statutea.
, t ~?as e~~ . kgal re~idaac o~ _ G ~t,~
SUr ' /l~ '~r .e~d I
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ZlS~~ ` O~ ~,~~e~ -~OM~rK~ I 6ave ehanaed aUr domicile to
latewt ~d N~s! ~
and aen aad luve baan a boaa Gde nsident ot the State ot F{orida sines ~7 ~
E ~ 18~ asd I reside at ~O• / Or`-' S/,
IStn~t ~i Nr~b~rl
~ ST. LUC 1 E ~u,cr.Floeida.
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aad thts statcment is to be taken as my deeLration ot eiti:ea~hip. ~etual kgal resideaee snd doaaicik ~u tl~e Stato oI Florida.
If POR THE PURPOSE Of ENROLIING If fOR HOMESTEAD PURPOSES~
CHILOREN IN SCH001.~ P~EASE STATE ILEASE CH£CK: ~
THEIR NAMES:
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i~~ ~ R NTY flA
- IIOCER r01TMs
CLEAK CIRCUIT COUIIt
ocr~A~ YERtF1E0.~.-~•~
- ~ A~ 6 3 26 PN'1T
3sz41s
I FURTNER CERTIF'Y that 1 will register at my local address when the registntion books reopea, and eomplr writh all
other requiremeats ot a leg~! resident o[ this State.
~ I R£R'~I that 1 have no iatention to- retnrn to mr focmer domicile. and I iotend to remain in
, ST . L ut 1 E , County,
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Fbrida, periri~ftiaaec?~t;. ~ :
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$K orn to and subscribed bcio~o me thi~ ~ day ot • ~
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A.D.19~7 -
ROG~ P01 TF2AS. CLERK OF G IRCUI T COl~2T
ST. Lt1G I E COIiNTY, f LOR t UA •
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E Y I.ERK ~
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