HomeMy WebLinkAbout2380 c~~ t~~r~€cil~ ~a~d Ci~~~~~s~~d~ r
ID~~l~
. 43299'7
i
TOTll F: CI.F:ItK OF T11F: CIRCUIT COt1RT, ,
ST. LUG 1 E COUNTY. FLORIDA:
This is my declaration of Domicilo and Ciliaonship In the State o[ Florida that I am tiUng this day is accordance. and In
contormily with Section 222.17. Florida S,l'atutoa. .
I wu tormrrl a legal resident of ~ ~y'PG' ~ SS/ ~LL°~/~ and I
/ / .(city) lState)
resided at ~o~Ho,~ry 2 2 L'ENTEwPE~ ~/L~ TiP_~ ever, I have changed my domicile to
(St»et and NumLar)
and am and have bcee a bona tide resident of the State of Fbridasince ~ ~.s/'~r~li~i~ day of
____.19~. and I reside at ,~,i2'~ 5•~~?sl>.~f
- (StrNt sad Nwaber)
,~~iP T S ? L ~/c ~ ~ ST . LUG 1 E County. Florida,
lpt~)
and this statement is to be taken u my declaration of citizenship, actual legal residence and domicile b the Stale of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK'
THE IR.NANESS
• ~ `FILED~ANO RECQl~ r.,..
gT. t.UC1E ~COUN7Ys A:~
• .F:LOaD VERI~IEO
4329
'~9 f E6 5 PM ~2 : 34 E
V ~ • 4
Ro~E~ ~olrQ s
CLERK CIRCUIT COURT
I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
other requirements o[ a legal resident of this Stale.
I FURTHER CERTIFY that I have' no intention to return to my former domicile, and I intend to remain in
~ 7 . t_ u ~ t ~ ~ .County,
k (City)
Fbrida, permanents; . ~~Z sl~1i~/..~J/N~ yE
~ ~0 2 S T L~ir~ E FLv.Pi ~/.9 ~~/Sz--
tk=
• w
~ _
~ - ~ Naau)
I ~y~ ~ s~~ h .y
~ (Addren)
Sworn to and subseriE?rd before Inc thi.9 day o! O/17"' S T Llle'/.E F~v~/
. A.I). l9_ ~q ~s Z-..
/
ROGER POI TRASH CLERK OF C IRGUI T COtjZT
ST. LUG I E COUNTY, Ft_OR 1 UA
BY:
EPU? Y •I.ERK
U R 3U2 ~ r23~ i~
c~
, ~ f
~ j