HomeMy WebLinkAbout2824 Declaration of Domicile and Citizenship ~1' .
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC 1 E COU~y~ trt.ORIDA;
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Thb b ao4y declaration of Doadcils and Citi>lonship i4 tM State of Flot3da that I am Wins thb dsy in uoordattos. and in
eontorntity whit Section 228.17. Florida Statutes.
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I wa tom a bgal resident of ~ + I
lOlUrl taNl
resided at ~ - - - However. I have ehansed aqr doaoieals to
l8tirt aed N~srl -
aad uaand have been a bona tide resident Ot the State Oir Florida ainee d+U? ~
1l.... and I reside at ~ ~s ~ -~.ew,ZL
, tea••t..aN~Mr)
ST. LUCRE ~U,~p~a,
ICWI _
and this statement b to bs taken as my declaration of dtiunshIp. aetnal legal residenos and domiede is the State. oI Fbrida.
• IP,POR THE PURPOSE Of
ENROt.L.ING If.POR HOMESTEAD PURPOSESi
' CHILDREN IN SCHOOt.s PLEASE STATE PLEASE CHECK:
THEIR NAMESS -
r'1LE0 ANp REGORGED'
=.i1ClE rOUNTY, FIA.
. i` VtrtiFii:D
~ --~~3304
'79 FES 7 P~ 12:51
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
other requirements of a legal resident of this State.
j I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
_ UC 1 E ~ County.
- ((Strl .
~ Fbrida: permanentl,.
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CO~Nl
cv . ~ - .
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T
(Naawl
~ IAddrwal '
Sworn to a d subscribed before me this day of t q ~ ~ -
9 IIr •
R ER P AS ERK OF CIRCUIT CQURT
ST. LUCRE COUNTY, FL tUA -
BY:
- E U L RK
~ BOOK PAGf -
4 ~ ~ ; r
ACO Form ZI -22
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