HomeMy WebLinkAbout0001 ' C~ecl~ra~ion of Domicile and C~tizenshi
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TO THE CLERK OF THE CIRCUIT COUAT. ~
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_ST,~,IuC I E . oovM~t. ~'i.oiuDA: ~ , . `
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Thb b mp declu+~tbn ot Domicile aad Citir.enahip ia tAe State ot Fbcida th~?! I am fiNng thts dq? ta secocdaaee. ~d ia - i
contocmity with Seetioa 222.17. Rlorida Statu .
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I Mu i resid t o~ ~ I ?
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reslded at ~ ~ • . No~?e~rer. I bave cbanged m~r domicile to
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am have boen a soAa fide resideat o~the State a! Floridt slnce . ~,r ~ ~
18~ sad I reside at ~ r
. lgt+wt wd N~erl
ST. lUG l E Couaty. Florida,
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- and this statcment is.to be~takea as rqy dcclari?tion ot eitiua~hip. actud kgd t~e.+tdenee aod doa~ici~e in tlie St~tto ot Florida. #
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Ii POR THE PURPOSE Oi ENROILING IP iOR HOMEStEAQ PURPOSES~
CHIIDREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~ ~
THEIR NAMESS = - i
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CLFRK CIR4__~1't C0U1lt
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I F'UR~HEK CERTIFY tlut I a~l register at my local addresa when the regislratioa books napen, and eomply with atI
otber requiremeats ot a icgat resident of t6i~ State. .
I I~'U E:t ~E FY t!?at i lu?ve ao tntention to return to m tonmr domicile. and 1 intcnd to nmaia ia
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Fiotida. pera~anenti;. ~ ~ - ~
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Sworn to aed subscr'bcd betore me thia day ot -
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ROGER PO( TRAS~ Ci.ERK OF C IRCUI T COUtT
St. L UG 1 E COUNTY, f LOR t UA •
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