HomeMy WebLinkAbout0868 Declaration af Domicit~ and L~t~zensn~~r
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M~ TO TE[E CLEItK OF THE CIRCUIT COUYtT. , ' • ;
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Thb b my deciaration of Domkile and Citizenahip ia tbe State ot Fbrida tA~t I am filing.tAb da~ in sc~ordaace, and tn
eoptormitr with Section 2~.11, Fbrids Statute~. '
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1 was tor.,~ rlr ~ legal sident ot ~~y~~ , and I
re~ided at ' ' . However. I bave changed my domicik to •
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and un and hare bcea a bo~a tide se~ident of the State of Flocida aince ~'Z'Q`~- dar of
~ 19 6 and I reside at ' ~ ~"~C -~4 Gl • ~ V I ~es' ~,5 ~O '
/~7~ ~ c%' (Str+st and N•ro6er1
~i /J,~.%s~ ST. LUG I E County, Florida,
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aad tbis statement is to be tekeo as my dcclsration ot citizen~hip~ aciual kgal resideace snd domicile in the State ot Fbrida.
If iOR T11E PURPOSE Of ENROLLING I~ POR HOMESTEAD PURPOSES ~
CNIIDREN IN SCHOOL~ PLEASE S7ATE P~EASE CHECKS
' THEIR NANES:
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~ IIOCER POITAAS
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I FURTIiER CERTIFY that I~vill register at my locsl addres~ when the registratioa books reopca, and comply with all
other requircments ot a Iega! resident o[ this State.
I FURTIiE3 CF. T FY t.I havc na intention to return to my former domicile. and I intend to remain in
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Florida. permanenci;.
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Sworn to ~nd subscritx~d before me this ,_____.L,,, dny of • --G'Q / -C~Z.. ,
~r.~.~l . A.b.19. 7 p -
ROGER POt 7RAS, CIERK OF C IRCUi T COU2T ~ ~
5T. LUGIE GOUNTY, F~ORIUA • ~
BY: ~
EPUTY LERK ' i
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~ d00K ~J PACE ~ ~
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Af,O Form 71 '
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