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Decl~ration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E COUNTY. FIARIDA:
This is my declaration ot Domicile and Citizenship in the State oi Florida that I am filing this day in accordance, and in
conformity With Sectioa 222.1?. Florida Slatutes. ~
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I was tormerly a legal resident of L . and I
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resided at ~ ~d ~ ~ . Howev . I hsve ehanged my domicile to ~
(Strs~t and NumMr)
and am and have been a bona tide resident of the State of Florida since ~ S^- day ot
.18_LL. and I reside at Q 7
~ l~ , ST ' L I Es~~x~eat .
i~,~~ ~ • County. Florida,
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and this statement is to be taken as my declaration o! citizenship. actual legal residence and domicile in the State of Florida.
IP FOR THE PURPOSE OF ENROLIING , IF FOR HOMESTEAD PURPOSES~ :
CHIIOREN IN SCHOOI~ PLEASE STATE' ' PLEASE CHECKt ~
TH IR NAME :
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I FURTHER CERTIFY that I will register at my local address when the registratioa books reopen. and comply with all
oiher requirements of a legal resident of this State. .
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I I FURTHER CERTIFY that I have no intrntion to return to my former domicile, and I intend 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 __L~L.- day of 5.~~~~^--C~ (~J`
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- ROGER P01 TRAS, CLERK OF C IRCUI T COI~?T .
~2 ST. L COUNTY, FLORIUA
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~ BY: ;
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, EPUTY LERK
30Gr V~t/ ~Ai:~ 93
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