HomeMy WebLinkAbout1280 - 430469
TO TILE C1.T•.RK OFTH>:: C1KCUIT COURT.
ST. LtK l E - COUI.TY. F1.oRinn:
This is my declaration of nomicile and Citiurnship in the State of Florida thst I am filing this day in acconlanco, and in
conformity with Section ?`'....'.17. Florida Statures.
ff/i'• /iyl'~ and l
I was formerly a lel;al resident of - ~IStatel -
lCityl
resided at ~ ~ l~• ~ ~ T ~Y~ ~ ---However, I have changed my domicile to
(Street and Rnn~h
and am and have been a bona fide resident of the State of Florida s~inco _ - ~ day of
hirt ~R~p~.t.~ 19~ and I reside at ~1 Q ~ fflG L I COi T
tStreK aad h+uuber) -
f~rf • ~hc ~ - ST. LUC 1 E -County, Florida,
(CltJ1
and this statement is to be taken as my declaration of eitiaenship, actual kgal rc - ?enc:; and domicile in the State o[ Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOLa PLEASE S7A71_ PLEASE CHECK2
THEIR NAMES.
- clt_E~ ,ZtI~J RECORO~O-
-•4~~69 .
'19 J~1! 11 PM 2.38
I FURTHER CERTIFY that I will register at my local adciress ashen the reti stration b~;:s reopen. and eornp'y with all
o.her requirerrrnts of n legal resident of this State.
s I }t3f{Tl)b:;t CERTIFY thzt. l have nn intention to mlun~ to my farmer domicile, rnd I intend to rrmain ir.
~ - - _-=~=~7 ."LUG t £ .County.
_ lCityl
}'loriJa. p^rnaanenti;.
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S~?•or • ~ptf sut~srrib~.•d t:cfori• n;i~ t1:i^ / da~• Af -
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~~y~ A.1). 19.,~ j
_,Cr~_PUI_TFrAS,_CI_(.l<K_(~F _C.1kCl11T COU1•
ST ~ +C 1 E CQ::~dTY, F L ~R 1 Utz
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