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HomeMy WebLinkAbout2773 ' Domicile and Citizenshi Declaration of p . 4369'78 i TO THE CLERK OF THE CIRCUIT COURT, ST. lUG 1 E COUNTY, FLORIDA: This is my declaration of Domicile and Citizenship is the State of Fbrida that I am filing thin day in accordance. and in conformity with Section 222.17, Florida Statutes. ~ ~ ...l,~ ~ l,J ~l0 i' ~ and I 1 I was formed a fgal resident of ~ ICI 1~~----• resided at q ~a C C- p Q ~ ~ t' _ However, I have changed my domicile to 18trsat and NumDar) and am and have been a boas tide resident of the State of Florian sines Mc.,~C~ 1 O day of .19J ! ' and I reside at I e~ 1 0 ~a~< me L A n~F (8teNt and NnmDar) 1 S~ ~ ~C e. - ST. LUG I E County. Florids. i l(Xty1 and this statement is to be taken as my declaration of citizenship. actual legal reaideace and domicile in the State of Florida. ~ i IF FOR THE PURPOSE OF ENROLLING IF POR HOMESTEAD PURPOSES, CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: THEIR MANES: ~ t~G ~ e _ _ ~,1~'. M ~o 4369'78 ~ j ?g I ~ PM ' : 18 f IFURTHER CERTIFY that I will register at my Ioca1 address when the registration books reopen, and comply witb all other requirements of a legal resident of this State. I FURTHER CERTIFY that I have no intention to return to my f~~er d micd„~. and I intend to remain in _ J 7. L rv c. ~ c minty. ICuy1 i ~ s ~ Florida, permanentl; . . ~ t I p• ~l ~~lJ fv i, w ~~~~e (A al ` Sworn to and subscn'bed before me this dsy of 1~ --~1.1~ ~ 33 y S ~ C~A_L.11 , A.D.19_ 79 ROGER P01 TRAS. CLERK OF G IRGUI T COURT ST. LUG i E COUNTY, FLOR 1 A . BY: EPUTY LERK I ~ I g~0!! ~4 r!?I:f 27 1 V • \f.(/ Form it n ~ ~ ~