HomeMy WebLinkAbout0037 Deciaration af Damicile and Citizenship ~
TO TNE CLERK OF THE CIRCUIT COURT, 4~~~~ '
ST . L UG 1 E COUNTY. FLORIDA:
This is my declaration ot Domicile and Citizenship ia the State ot Florida that I am filiag this day in acrnrdance. and in
cunformily with Section 222.17, F'lorida Statutes.
~ Los
1~as furmerl a legal resident o! ~~~r/'~Q~~G G. and I
ICit7~ IState)
rrsided at s ..G~v~/~G~ 2-i.' ~•~L~GC . However. I have changed my domicile to
(Street aod NumDer) ~ ~
and am and have been a bona fiide resident ot the Stste oi Florida since day oi
_ ~_~~/L~'/~-~ .19_~~, and I reside at ~_7 ! ` ' ~l TLE .sG~ C1~
. (Street aad Number)
~2' ~ . ST . L t1G 1 E Couaty. Florida.
l~tic~1
and this statement is to be taken as my declsration of eitizenship. actual legal residence and domicile in the State of F'lorida.
IF FOR THE PURPOSE OF ENROLIING IF FOR HOMESTEAD PURPOSES~
'CHILOREN IN SCHOOL~ PLEI?SE STATE PIEASE CHECKS
THElR NAMES: ~
~S~ini~ ~j~ill~.~/ /~i<<l/_ S ,
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I FURTHER CERTIFY that I will register at my local address ~hen the registration books reopen, and eomply with all
other requirements of a legal resident of this State. -
' I FURTHE~ CERTIFY that I have no intxntion to return to my tormer domicile, and I iatend to remain in
~ ~ ~ ~ T. U C 1 E . County.
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~ Florida, permanenti~. '
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~ Sworn to and subscribed before me this day of • - ~ ~
~ , A.D.19_ ~9 J
7 I
ROGER P01 TRAS~ CIERK OF C IRCUI T COl~2T ~
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; ST. W~i E COUNTY, FLOR 1 dA ~
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- BY : .
~ EPUTY LERK
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