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Declaration of Domicile and Citizenship
43634 -
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E COU~Y, ~,O~pA; .
This is my declaration of Domicile sad Citiuaship is the State of Florida that I am iDing this day in aooordaace. and in
conformity with Section 222.17. Florida Statutes.
I was formerh? a legal resident of T 1 ~ UR ON r ~-L 1 ~O R 1J ? ~ and I t
. IGtity) 18tat~)
resided at 1 1 ~ LYF ~Qn ~R I U Ir . However. I have changed my domiri7e to
ISwet and N®bar) t
and am and have been a bona fide resident of the State of Florida ainoe T ~ E F 1 RST day of ~
~ A A1lA CRY .19
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- and I reside at 1 ~ 4 a 6U res~.IN DY ,L (~~J E
IStreet asd Number)
POKT Sl' 1r uG t E ST . LUG I E qty, tea,
ICKyI
and this statement is to be taken as my declaration of citisenship. actual legal residence and domicle in the State of Fbrida.
IF FOR THE PURPOSE OF ENROLLING IF FOR .HOMESTEAD PURPOSES
CHILDREN IN SCHOOLr PLEASE STATE PLEASE CHECKL
THEIR NANESS
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1979 HAY -8 AID Il~ 0$
f~eo ENO NECOKOEO
- stLUCIE calul Y.fIA.
CLERK
Ca~I C AS ~
RFCORb YER~f1Ef
443634
I FURTHER CERTIFY that I w~11 register at my local address when the registration books reopen. and comply with all
~ other requirements of a legal resident of this State.
E
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
i ~ T. U C I E County. `
1(~ty)
Florida. permaneau;.
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..~tr''~t ;:?~ti:10?°t'`~ /Name) '
l~9 a ~«a~~ l1N oy_ LSE
I~da~..ei
Sworn to and snbsrn'bed before me this day of ~(~QT' S3' LU~C,1 ~ _ ~'L-
A.D.19_
~n~ .79 -
ROGER P01 TRAS, CLERK OF G i RGU I T COURT
ST. L UG I E COUNTY, f LOR 1 DA
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EPUTY LERK
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