HomeMy WebLinkAbout1628 Declaration of Domicile and Citizenship
X34469
i
TO THE CLERK OF THE CIRCUIT OOURT. -
ST? L UC 1 E COUNTY. FLORIDA: .
ThL b ~1 declaration d DomicDe and t~tiaanahip is the State d)<7orida that I am 81Ina this d~ in aooordanos. and is
contormiq' with 8edton 228.17. Florida 8tatutee. ~ _ .
L~/~S' 7~i sF ~/or'f~t r4 fi/ O ~ andI
I was i~ a kgal resident d
ICft~l t
re:iaea at Lf d S 7 ~ `i S'~'"' _ However. I have ebanaed mU? domie~a to
1&er.t.na xae.rl
and am and have been a bona Sde resident d the State d Florida dnoa ~~~r !
~
~ f d aT d
1p - and I reside st I Q 2 S E • s 11 ~ f.-eJL p~`-
tgk..c..aN.a~e.r1 - .
r- f S?'• L UC i t'-- ST. LUG 1 E Connq. Florida,
cc~ai
and this statement is to be taken u m7 declaration d dti:enahlp. adnal legal residence and domicDe b the State d 1<7orlda.
IF FOR THE PURPOSE OF ENROLt.iNG IF FOR HOMESTEAD PURPOSES, _
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEtR NAMESS
s ~ - ~ -
I~/.~ /t/ % ~ F{LED AND RECORDED`
i f~CiE GQUNTY. FLA..
- Vc~t_'~'~
~ r s X34469
- '~9 FEB I9 AM i ~ ~ 54
S: ~ H~-~ T .
I FURTHER CERTIF7~ that I wRl register at mT local address when Lbe registration books reopen. and comp~j? with aD
other requirements d a legal resident d this State.
k ~ ~
I FURTHER CERTII~'Y that I have no intention to return to m~ former domicile. and I intend to remain in
` - C 1 E ~ Connq.
1C~1 t
Florida. permanensl,,•.
~,as~~t~1113 A,;~~~~ .
:_j' 1'
. , 7^:
t~ L,:=
~ v _ ~ _ ep, Sj
Sworn to and subscribed before me this _..,L2- aw d -
- A.D.19_ ~1
ROGER P01 TRAS, CLERK OF CIRCUIT COURT
ST. LUGIF COUNTY, fLORtoA
BY s ,p~~j
~ EPUTY LERK
~oox303 ~E1626
- a
- ..g.
s}~~ ~ ..y:pam~
i4 -5
r. .