HomeMy WebLinkAbout0725 ~ Deciaration ~ of Domicile and Citizenship $
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Thi~ ~ aq? deelaratioa ot Domicile and CiUsensbip irr tbe Stat~ oI Fbeida that i am ~ this dq in aeooedanes. ud ia ;
ooatormitr with Sectioo 222.17. tlorids 3tatutes. . ~ ~
t Mu t rt a kgai res~d.ac ot , ~iN~ ~~ri-T u L! : ~ ~
[ (Cfy1 • . 18Wd
resided at 1~.~ C S.TO 1.1 ~.W wl~ - - Howwtr, I haw chanasd m~? do~ieile to
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Idtrwt a~d Nr~b~rl
asd aa? aad havs been a bau 6d~ reaid~nt ol tlre 3tat~ ot Florida siaoe dap ot
'~~J ~•1~ .1~ aad I reside aR 1 ~n 0 C CL~SP ~~~?T ~ i
l8t~t nd Nmb~i •
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ST . l- v L~_ ~ ST. LUG t E Counq. F7orids.
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and thb statement ~S to be tak~a as m~r declarattoo ot dti:enship. aetual kgal resideuae and do~i~ile in t~ 3tate ot Floeida.
IF FOR THE PlJRPOSE Oi ENR4LLINC ii fOR HOMEStEAO PURPOSESi
CMILDREN IN SGHOOI~ PIEASE STATE P~EASE CHECK: ~
THEIR NAMES:
µ ~ ~~L ~ . ~ ~ F LED AND RECORDE~
3~. ltIC1E COUNtr il~
ROCEP POlTR~S '
A~,~,t..~-~CW ~ ~ ~ 6~ C' ERK C~~~U{1 COUR -
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I FIJRTHEB CERTff'Y that I ~?ill register at m~ IouJ addresa when the ngistntion boolcs nopet~: and eomply w~ith all 4
ot6er requirements ot s legal resideat of this State. ~
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I CERTIF'Y that have ~nttetion ~ Lo return to m former domicile. and I intend to remaia ia ~
F'tnEtTf~~et~' ~T- ~.r G•T~e ~ ~T . L UC 1 E : County. ~
((:it~l . _ - 3
Florids. pernusnenti~ . ~ ~
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c'' ` } , Co3/ S•E- CALruosi4 !
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C~E COUNIY . F~' ~,?aalel ~"'r' C~. v G t G t r~'~
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Sworn to and subscribed betore me this ~ day ot j
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- . A.D.19. 7 8 ~
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ROGER POI TRAS, CLERK OF C IRCUI T COUf2T ~
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ST. L l1G I E GOUNTY, F ~OR 1 UA • ~ ~
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BY. - :
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EPUTY IERK Q R i
aaoK 288 ~~E ~
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