HomeMy WebLinkAbout0114 • ~ ~ • • • • , ~
Dect~ration of Dom~~~te and Citizensh~p
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• ~ 3~~,52 ;
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TO THE CLEAK OF THE CIttCUIT OOURT. -
_..~s LUC I,E ~COtlrirsr. ~'sroiuo~
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1'fib b nyr d~daratba ot Doaaiejie ~ad CJti~sbip ta tbe Stat~ ot Fbeida that I am fil~ ti~ dy ia ~oordanos. ~nd ia
~oafonaity with Seetioa 222.17. Flalda Statuta.
I wra t a Ie~al resident ot ~ I
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t+~W~d at " Horwvet. I bare et~aaag~ed ay? dankile to
. 1~t a~i Naa~tt i
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aad aa snd ba~e beea a boe~ tide resident ot the St~te oI Florjda ~iaa ~ - da,y ot
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~ lt_,~. ~sd I c~id~ at - / ~ ~ .
1SteNt s~d Nti~1~
~ ,,G~~ ST. lUG t E Councr. Florida
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' ..aad t!~ ~tate~ent b~o bs taken u n~r declar~tbo ol dttun~tp. aetua.l kgal nsideaee ud do~nie~e in tl~e State vt florida.
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IF fOR TIiE PUR?OSE~OF. ENROLCtNG IF iOR HOMESTEAD PURPOSES~ ~
~HI~OREN IN SCHOO~~ P~EI15E STATE ~ ?LEASE CHECK: ~
THEIR NANES~ ~ _
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. ~T.I.IIC~E
P~$~A. -
ROCER T
~ CIERK CIRCUIT COURt
vERtflEO
_ Al+r 23 27 W7' _
• - ~ 3'~6152
1 FURTHER CEItT:~'Y that I w?ID regiSter at w~ loc:l addras ~rhen the Yegistntion books reopea. snd eomply ~vitb sll
otlaer t+eqairtmeats oi a kgal sesident ot this State. ~ ~ _
- I FURTHERJ ~CE$TI ~ that I Aave ao int~atan to retnm to m former domic,~e. and I iatcad ~W remain ia
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F{orida. pesmanenci;.
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Sworn to ~nd snhscrIhed bctore me tl~ts d~y ol , .
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A.D.19~7~
~tUGER POJ TRAS. CL~RK OF' C 1RCU1 T CQl~2T ~
SY. lUG I E COUNTY, f L.OR 1 UA • ~ .
: BY: - . .
x LPUYY ~ERK
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~ , 600K ~i•~ PACE .
. A(if! }'~.r~~~ 71.r'
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