HomeMy WebLinkAbout2172 +•e
Dectaratian of Damicite and Citizenship /
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4:3848'
TU TIIE CLEItK OF THE CIRCUIT COURT, '
ST. lUC 1 E COUrIT1r. FLORIDA:
This b my declaration of Domicile and Citizenship in the State of Florida that I am filing this day is accordance. and in
conlormity with Section 222.17. Florida Statutes.
I was formerly a legal resident of " AS / ~ ~ ~ ~~C ~e/wh~and I r
(gtyl (Stahl
resided at G ~ . However, I have changed my domicile to
(Stee~t and NumEsr)
and am and have beon a bona Gde resident of the State of Florida since ~-s r'~ day of
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19~ and I reside at l! ~ ~ / nil ~ ' ~
(Strset and Numbarl
^_____T 1 F'~(1 _ . ST. LUG 1 E County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile is the State of Florida.
IF.FOR THE PURPOSE OF EMROLLiNG IF -FOR HOMESTEAD PURPOSESa
' CHIIOREH 1N SCHOOIa PLEASE STATE PLEASE CHECK:
THEIR/ NAMES: _ ~n
C~ ~ A) f? ~ C
• Fib Fp :.h C; ~t~CORCED
- - ~ ~r:c" ^nU'`TY. FLA.
4:3848'7
'79 I~t~~~ 26 AM ICS : 34
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j I FURTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
~ o! her requirements o[ a legal resident of this State.
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I FURTHER CERTI that have no intention to return tom former domicile. and I intend to remain in
{ U C 1 E ,County.
tCit~)
Florida. permanenti;.
& courrry .D H, s ~u.nr~
(,~ErK
V r 4. = L' ~ 1
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S k•orn to and subscribed before me this v day of ~`~C) / /lLF ~-Z
s A.D.19_
ROGER POI TRAS. CLERK OF CIRCUIT COURT
G T, L UG I E COUNTY, F LOR 1 UA
BY: _
EPUTY t.ERK
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