HomeMy WebLinkAbout0818 Declaration of Domicile and Citizenship
43'7694
TO THE CLERK OF THE CIRCUIT OOU~iT. .
ST. L lJC 1 E ~pl7NTy. 1~-I,pRIDA: .
This is deelaratioa ot Domit~e and (~itisenship in the State oi F7orids that I am filing thL da~ in aooordaaoe. and in
coniormit~ w~itb Seetion 222.17. Florida Statutes.
1 was former~ a legal resident of ~,P. A~ d t 1~' r/ ~i~. ~PJ/.'~ ~-S ~J and I
l(xtJ) ~ (8tat~)
reaided at ~ . Ho~rever. I 6ave e6anged m,~ domicile to
(8t~t a~d NasDK)
and am aad ha~e been a bona Sde resideat d t6e State oi Fbrids since yC~~ dq o~
rn¢~_ 192~., aad I reside at 3 Sr ~~'i u rr~ ~.Ij
(~t aed Nt~~t)
~l) ~ t Sf 1. 4 c i~°, ~ ST . L UG 1 E Count~. Flocida.
' e
0
aad this atatement is to be taken as m~ deelaration of citiunship. aetual kgal reaidenoe and domici'k in the State d Flarida.
IF POR THE PURPOSE Oi ENROLLIkG IF FOR HOMESTEAD PURPOSES~
CHIL~REN IN SCHOOL~ PLEASE STATE P~EASE CHECKS ~
THEIR NAMESS
~ C-/ ~ S~~ 7 h Q/h~-s' d~?)
d .Y 7 ~ - ~ ,._~c~~?~ ~ ~
/'h SZ~ . : =
~3'7694
'79 ~ I ° ~~i ; ~ : 52
~
. . . -
. F
i
I FURTI~R CEBTIFY that I w~l regiater at my local address when the registration booka nopen, and oompl~ witL all
other reqwrementa of a legal reaideat oi thi~ State.
~
j I FURTHER CERTIFY that I have no intentioa to return to m former domie~e, and I intend to remain in
' . U C 1 E , . Count
i y'
z (GSt~) .
s
g Florida, permanenti; . _
; -
~ •
S
s
~ ~
~ ~ C`.~~
~ - ' ~ J• ~.,T... ,p
= ~ ~ ~ s 1
N~ ~ r J. : y ~ .
'.yC ~ ~
:O
; !GC'EC~UNTYJf~~P\oT ~ ~r~f ~
Q'1am~) ~
- ,~C~~~ .Sf~ .(~~~°i P_
~ c~aar...t
~ Sw~orn to and aubscnbed before me this day of
__~.~~2~! . A.D.19_ ~1 -
~
- ROGER P01 TRAS~ CLERK OF G I RCUI T COI~tT
3 •
~1 ' '
ST. LUG 1 E GOUNTY, f LOR 1 OA
~ .
r'j ~ • . •
~ BY:
,
~ EPUTY IERK ' .
.
'
9C'Cr tl~tJ i~~ 817 , .
.
.~r~ F~..~. ~
~