HomeMy WebLinkAbout0875 . . : . ~
Deciarat~on of Domicile and Cit~iensh~p ~ :
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TO THE CLE~tK OF THE CQtCUIT OOURT. i
ST. LUC I E apU~y, ~,p~w: .
T'his b m,~ deelaratlon ot Domic~e and Citisenship in tM $tate of Florida that I am Slins tAis dq in sooordanoe. aad in
oontormity witb Scctioa 222.17. I~7o:ids 8tatutes. ~
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I was forme~rl a kgal resideat oi /~'G~1~1c.1~ aad I
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resided at ~ C~~LLI~ - However. I h~~e ehanged my domicik to
(8t:..t a.d Alns~) ~ ~
and am and Uave been a Dona 6de resident oi the State d Fbrida sinoe ~~+Q~tl~lt~ ~5~~i~C/ da~ ot
19~ and I reside at v~~ //I~N7! ~.l~cet-G!/ ~
-T~ (8tewt ~d I~lomb~rl
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aad this statement is to be taken as aU deelantion of eitizewhip. aetwl kgat residenoe and domieik in tbs 3tate at Fla~ida.
IF FOR TNE PURPOSE OF ENROLLiNG IF F'OR HOMESTEAO PURPOSES~
CHIIOREN IN SCHOO~~ PLEASE STATE PLEASE CHEGKS ~
THEIR NAMESZ
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~ I F'URTHEB CERTII~'Y that I wnU ngister at my local address when the registntion books reopen, and oompl~ w?ith all
~ other reqninments oi s 1ega1 resident of t6is State. - `
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~ I 6ave p0 I11LtphOp to retwn to m former domic~7e. snd I intend to remain in ;
` u c E County, E
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~ Florida. permanenci; .
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~ sworn to and sabsen'bed betore me this ~ 9 da~ of " ~
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ROGER P01 TRAS, CLERK OF G iRCU1 T COI~tT :
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~ sT. ~uc i E couNnr, FLoR ~ oa . - =
~ BY: ~ / • - - . : .
~ ~C~'1'Xl~.~./
~ _ EPUTV RK ~ ~ - '
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~F 90Gr ~~V '~11./~ V ¦ ~ ' ~ •t- AGO Fnrm 7l ?2 -
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