HomeMy WebLinkAbout0239 Deciaration of Domicile and Citizenship
4:~~51'7
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COUNTY. FIARIDA:
This is my declaration ot Domicile and Citizenship ia the Stale ot Ftorida that I am filing this da~ in accordanee. and in
conformity with Section 222.17. Florida Statutes.
I was formerl a Iegal resident ot ~e u1 ~ D rl • V~ I
IStste
resided at S S
S- Crvc..s rl S'-~' A-D~' ~ C ~Y 8 roo (LG.., n. . However. I have changed my domicik to
(3treet and Nu bu1
and am and have been a bona tde resident oi the State of Florida since b~` day of
l~ n~~ P.,1 h Qiv . 19~~.. and I reside at I~~.~, ~v' ~ F~~ v~ ~~'v ~ e.'~ . _
- - - (3tre~t and NumMr)
1~o r~' S't ~.u c~ e ST . L UG I E Count~. F7orida,
1(~t71 ;
and this statemeat is to be taken as my declaration of citizenship. actual legal re~idence and domic~ in the State of Florida.
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If FOR TNE PURPOSE OF ENROLIING IF FOR HOMESTEA~ PURPOSES~ 1
CHIIDREN IN SCHOOL~ PIEASE STATE PIEASE CHECK: '
THE IR NAMES: 1-'--~
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'~9 FE~, 27 P~1 3: 39 ~
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I FURTNER CERTIF'Y that I wi71 register at my local address when the registration books reopen, and comply with all
i other requirements o~ a legal resideot of this State.
I FURTHE~ CERTIF'Y that I have no intention to return to my former domicile, and I intend to remain in
, , i. ~ ~ ~ ~ c County.
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~ Florida, permanenci~.
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Sworn to and subscnbed before me this day of ' i r, r '~t ~ ~~F t t~ ~~~1« 4`'-:'-
r 0-/1~--, , A.D.19_ ~
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ROGER P01 TRAS. CLERK OF C i RCU I T COl~2 T ~
ST. LUG I E COUNTY, F~OR 1 DA _
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