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Declar~tion of Domicile and Citiz~nshi
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TO THE CLEItK OF THE CIRCUIT COURT, ~
ST,~ Ll1C 1 E CpUt~r1~Y~ FLORIDA:
This li my declaration ot Domicile and Citiunahip ta the Slata o[ Ftorida Ihd I am filing thb d~y in aecordanoe, and in
conformity wiLA Section 222.17. F~lorida Statu/ea.
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1 wu to~ a kgal resldent ot ,;c_ L~~ S 0~ ~ S C s,~(Si.tJ and I
Q 1~?1 (St.t~)
resided st T 1 ~X 3D 2 . HoMever. I have changed my domicile to
(Stee~t aod Num~d ~i~'
,~nd am and have beoa a boaa 6de resideat ot the State oI Florida aince day d
O e~/1~ I~ ~IlL-L~/+~i C^ IFri~•t.t MAAJ I~~J~~
~C ~ o~ C~° ,19~ and I reside at 2. D D S. ~ L' E.4-wJ i?t .
~ (8trat asd N~b.d
/r~l: E~ C~ _ ST. LUC 1 E Count~. Florida.
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and thi~ statement ia to be taken u m~r declaration of citiuashlp. artual legal residence and domic7e in ~be Stata ot Fforida.
If.F'OR THE PURPOSE OP ENROlL1NG IF iOR HOMESTEAD PURPOSES~
' CHIIOREN IN SCHOOL~ PIEASE STATE . P~EASE CHECKS ~
YHE iR lillMESt ~ .
, F!LED AND RECORDE01
S7. LUC1E CDUNTY. FCA~
..FCpFO ;~cR~:.tED
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'T9 MAR Zg PM 3: 3I _
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. Ri'GER POITR~~ ~
CLERK CIRCU{T COURT•,
i I FURTHER CERTIFY that I w~11 register at my local addcess ~rhen jhe ngtstration books nopen. and wmply ~vith all
E other requirements o[ a kgal resideat of thit State. '
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~ . I FURTHER -CERTIE'Y that I have no intrntion to nturn to my [ormer domicile. snd I intend to remain in
3-"'-"- JT . i. u c ~ r , Couaty.
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F{orida, permaneaLi;.
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~ K~orn to and subscribed 6etore me this da~ of ~G~' ~4~ v(L ~L'~"r't'~i4N~-'~~~Z3.1~`~ ~
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ROGER P01 TRAS, CLERK OF C I RCU I T COU2T
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S T. L UG I E COUNTY, f LOR 1 UA •
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EPUTY IERK ;
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