HomeMy WebLinkAbout0676 Declaration of Domicile ana LrtiZensn~p
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N~ TO Tl~E CL.BRK OF THE CIRCUIT COUAT, , ' • :
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t~tir~, ~'~tur~~:
'Phts Ia my deeluatian oi Domic~le and CiL'uenship in tAe $tate ot Flortda that 1 am Wi~g thta d~r in aceordaaee. u~d in
confortaity wttb Section 222.17. F1orlds Statu~ '
1 ~?as torm~rlr s kgal rasident ot _ L G J 7
t,,.~i `y iti
resided at ~~..1~~„_~~ ~
t~ . 1S`~ . Nowever. I bave ebs m domieik to •
(BtrMt wd NumDer? n8'~ y
•nd am and have beeA a bona fide resident of the State oi Fiorid~t aince _.:~L,~ dar ot
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= 19~..~and I r+eside at SO U~~, 1.T~
~ tSteret ud I~tumMri .
. ST. LUG i E co„atr. ~o~;a..
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and this statsment is to be taken as my dectaration of citisen'shiP. aciwl kgal reaidenee and domicile in tbe State oi Florida.
If FOR YHE PURPOSE OF ENROt~tNG If FOR HONESTEAO PURPOSES~
' CHIIDREN tN SCHOOL~ PtE/1S~ STATE PLEASE CHECK: ~
' ~ THEIR NAMES:
. ~4 ~ C.~~ A~ -
~'IZ1e ' ~~R; ~ . _
' F~LEO AMO RECOAoEC
~T- tuCiE COUNtr i
. ROCER POITRAS
CtfRlt CI4CUIT ~QU T
='F~En
~ " Aus 19 2 a6 PN'~ • t
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I FURTHER CERTIFY that I will register ~t my local addres~ whea tht registralioo books reopen, and comply with sU
olher requirements ot a kgal reside~t o[ this Stete.
I FURTIIF C ltTIFY at I have no intr~tion to return to my tormer domicile. snd I intend t~ remain in '
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Florida, pcrmanenti~.
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Sworn lo and subscriLc~d beforc mc this day of ~S,]'~i i
. A.D.19. 7 ~ ~
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ROGER P T AS CLERK OF C RCUt T COU2T _ ~
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ST. I~ COUNTY, f LOk 1 UA • s
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EPUTY L~RK '
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