HomeMy WebLinkAbout0648 . . . . h.
Declarat~on of Dom~c~le and Cit~zens ~p
~ 4:3'7Si36
TO THE CLERK OF THE CIACUIT OOURT.
ST . l UC 1 E ~pU~y. ptip~pA:
This is m~ deelaratbn ot Domicik aad C~tisenship in tbe 8tate ot ~'brida tbat I am SHng this da~ in aoooTdanos. ud 'w
coatormity witb Section 222.17. I~'lo:ida Statutes.
I~+u former a legal resident at ~~n~a-- . 4(' ~ and I
1(~~) l )
st oZ l 3(` Q ~00 S 0.c.,~XL'~e E. _ Howevar. I h3ve ebanged nq~ domia7e to
lBhMt a~d Nm~br)
snd am and have been a bona Sde nddent ot tLe SW,e at F7orida sinoe ~ da7 ot
r'la..C'c~n .19~., and I reside at 1 O~O l S•~. R.(J .
' l8tt«t a~d H~eabKl
P~e~~ e, , ST. LUG I E ~ti.~;a,,
and this statement is to be taken as mp dee4ration of citisenship. actud legal residenee and domicile in the 3tate ot F1orlds. ~
IF FOR THE PURPOSE Oi ENRO~LiNG IF FOR HOMESTEAD PURPOSES~
CHiLDREN IN SCH00l.~ P~EASE STATE P~EASE CHECK:- ~ -
TNEIR NAMESI
J es s e (Yl ~ c ho~e...l
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-Tar,ua., h~a.~,ec-~ne . - , , __~j;~:
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?~g ~ 16 P~;~1 i : 00
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~ I FtJRTHEfi CERTIFR tbat I w~l register at m~ bcal addnss wrhen the ngistration bool~s r~eopen. and oomplp with all
E other nquinments of a legal nsident of this State.
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¢ I FtJRTHER CERTff'Y tliat I have no intention to return to m former domicik. aad I intend to remain in
E r C-~ . U C 1 E . Co~nt7.
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~ Fbrida. permanenti; .
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~ S~vorn to aad subseribed befc~+e tue this ~ dy of i El'Z y, F~ C~ .
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ST, r~l:EJ~~E: COUNTY,. =~~OR 1 OA ~
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