HomeMy WebLinkAbout0473 uectara~~on ot uom~c~te ana L~t~~c;r«r~~~
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TO THE CLERK OF THE CIRCUIT COURT, . '
ST. LUC 1 E ~pUNTy. Fi,pRlDA:
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TAb b m~r declaratioa ot Domic~le and Cititenahip in the St~te ot Fbrida that I un Gling tAts dqr ia sccordance. and IA ~
eoatormity with Seetion 222.17. Florida Statutea. ~
I rna formeri • le~al reaident ot ~ T~~ ~ , vt~'A and I • ~
. lCitl?) IStaW
resided at 65 ~ ~ ~~2Q~.'t~,A,~._~~ _ -.Ho~rever. I t?sve changed nqr domieile to ~
~ lSteNt ud NwnOKI •
and am and have been a boaR fide resident ot tl~e State ot Fiorida'ince ~U day oi
I^G. 19_~, aad I reaide at Q~ ~ A4 Ag~„_,~~.-.._.A~.. ~
Ist~ris aad Nwnees)
~~f ~,,rTQG _ S7. L UG I E CouAtr, Floriaa.
ICIt~1
" u~d thu statement ts to be taken ~s my declar~tion of titiuitsT?fp, actual legal re~idence aad domic~e ia the Statc ot Florida. ~
If fOR THE PURPOSE OF ENROILING Ii FOR HOHESTEAO PURPOSES~ ~
CHIIOREN IiJ SCHOOL~ P~EASE STATE PLEASE CH~CKS ~
THEIR NAMES:
~ f LE ANO'REC A EO ~
- r r~ s~. AOCER~POUTNAS tA.
CLERK CIRCUIT COUAT
arrnr ~'ycR1F1~D
A~c 15 9 2i ~!I'1~
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I FtTRTNEft CERTIFY that I wi1[ registee at my iocal address when the registntion books reopen, and tomply with aq
other reguiremeats of a ~ega! resident of this State. "
I FURTlIE.Z CER1'I thst I have no intention to return to my former domicile. and 1 intend to remain in -
' ~ t. ~i ~Qt~ ~ ~T . L U C 1 E . County.
((1tT) . .
Florida, permanenti; .
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IName
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SKOrn to snd subscribed betore mu this ~ dnr of ~r ~f~
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• A.D. 29~? -
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ROGER PO i iRA . C(z,ERK OF C! RGU I T COIxtT
ST. LlIG 1 E COUNTY, F~Oft i UA ~
8Y: . ~ • , .
EPUTY LERK
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