HomeMy WebLinkAbout0923
, Declaration af C~omicile and Citizenship ~
. . ~
. . • ~~~r ~ ~
TO TEIE CL6RK OF THE CIRCUIT COURT. ~ ~ , ' • ;
• ~
' ST. lUC f E (~pUNT'Y~ FLORiDA: -
Tbis b my dccia~~tion ot Domteib and Cjt~en~hip in the State oi Fiorida tA~t I am filing ihia da~ ia accordsaee. ae~d ia
ton(ormity with Seetion 222.17. Florida St~tutes. '
I was lorm~rl,~,? a kgal naiaent o[ ~~n ~ . ~nd I
1~ tSt~td
resided at r~s l~~ ~ t/" . However. I have changed my domicik to ~
~ .~a HymeK~
•nd am and have been ~ boas fide nsident otthe State ot Fiorid~ eiece 4 day ot
~ ~
C/y , I9 ?
S_, and I re~ide at ~ ~ f
~9wJ %
(Stewt ud Number)
~,t~ i~. ~ C _ ST . L UG 1 E Co„pc~, E'lorida,
~
~Gc~1 ~
and this statement u to be taken u my deetaration ot eitizenship. sctual lcgal nsidenee aad domicile in the State ot Florids.
If FOR 7NE PURPOSE OF ENROLLIKG If' F'OR HOM~StEAD PURPOSES~
CHIIDREN IN SCHOOI~ PLEASE STA7E PLEIISE CHECK: - ~
' THEIR NAMES:
/i~EQ RNO IIECORpEO
31. tUCIE COUMrY ftA.
. t10CER P01tAAs
CIERK ~:~CUIT COURT '
- _ .~~,~,.~.y~
AIl~ ?9 2 06 PM'7 =
. ,
.
41534'7 >
~
~
I FURTIiER CERTIFY that I will register at my local address when the ce~istrstion books reopen, and comptp with all
other requircmcnts o[ a kga! resident oi this State.
I F1IRTIIFy C~jRTIF'Y t t ve no intention to return to my lormer domiciie. and I intend to remain in
i l l~',~- , ST . L uC 1 E , County.
- ICit~) .
Florida. permsncnci; ,
`i` tyl~:ii~:ij! .
~F//~
% C r~:
~ ~ J ~ ~ ~
. ~
t~,
aj~ a~. U~4 ~ . ` '
- ~ ''~r~'`•,~~~ Gt+i:..~.: /
. ~ ` ~arF-:-•~ -•I,, ~ ~ ~ Z ~ ~ -
• "t'F'. : .
~ ~ ~p. . . .
~v-. . •
~ Vrf' : = O < ~ (~/°~C-
~ ' . : d'1 ~ -
j J~'~" ' ` = ~-Y ~~~~~~~1/
~ il.
~i . ~ J ~~'s....•• Nuu~ ~ L/
G ~P-~~~, / C_ jSZ
J~= t t 1Nttit IAddreu)
Sworn to ~nd subserit,cd ~efore trie ihis ~ day of ~_`f ~
.
. . A.D.19.7~ c~,
Q N ~ ~ . •LJ~2Sr
l20G~R P TRAS, CL.ERK OF C(RCUt T COURT ~
ST. lUG1E GOUNTY, l. 1UA •
~Y : '
EPUTY IERK . ~
. ,
. ;
~ ~ooK ~~J~7 ~a~E ~ ~ ~
.
ACQ F'orm 11 ~
_ _..r,_ _ " '
- . ..r.Y.. , . _ - ~ ~
.