HomeMy WebLinkAbout0915 ~ Decf~r~tion of Dornicil~ and Ci~iz~nship
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TO TNE CLBftK OF THE C1RCUIT OOURT,
ST. L UG I E apUt~rry. t~'t,pAIDA: -
~ '11ds b mr deeta~atioa o[ Domieile and Citisenship in tM Stat~ ot Fbrida tl~at I ant filtn~ this dyr in ao~ordanee. and in
contonaity with Section 2~.1T. Fbrid~ Statut~a.
I~ra tormcrl a kaal resideat ot ~ S~`~ N ~ I •
1~71 1~
r~sidsd at ~ v~ 1 R~ ~ a Q~~ ~~v - Ho~rews. I haw elun~d aar domieile to
1 a~d NwN~I .
and au? and have been a bo~a Cde raideat oi tbe Stat~ of Fbcida siac~ aGPoK . ~ar ~
ciN ~ ~ 19_[~_. aud I c~sWe at S ~ O~ pa ~~?')L ~ ~1 ~ 1
1~en~t ~ N~MrI
~ ~ 1~~~ 2 cf' ST. lUG I E Con4ty. F~oclaa.
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' and tbis rtatemeat b to be takea u my deelaration ot dtizenship, aetual kga! residenee snd domie~'le in tbe State ot Fbrida.
If FOR 7HE PURPOSE Of ENROLLING Ii iOR HOMESTEAO PURPOSESi
CHILOREN IN SCHOOI~ PLEASE STATE . ~~EIISE CHECKS ~
THEtR NANES:
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Ju~ z I 10 06 AM'11
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I FIJRTHER CERTIFY that I w~71 register at mr local address ~vhen the tegistnti~on books reopeo. and eomply rvith aU
~ other requiremeats ot a legd resident ot this Stata. ' :
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~ I FUItTHEZ CERTIE`Y tlut I have no inteation to return to my • focmcr dania'le, and I intend to remaia ia
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~ Sworn to ~nd.subxribed bctore me this dar oI r~ P~~~<< ~
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- A.D.19~ i
~ R S C ERK OF C IRCUI T COUtT
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ST. l UG I E COUNTY, F I.OR 1 UA • '
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P uT Y~ E a K d0otcz 1~ ~tE g15
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