HomeMy WebLinkAbout1674 Decla+~ation of Domicile and Citizenshi ~
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443939
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COU~•Y~ FLORIDA.
This is my declaration of Domicile and Citizenship in the State of Florids that I am filing this day in :ecordanoe. and in
conformity with SM.ioa 222.17. Florida SGtatutes.
I was formed' a legal resident of ___r ALL ~ ~ U E _ ~ SAC ff ~~GZT S and I
IAty) IState)
resided at _ - ~ 3 3 F ~ JR! N t~ ~"T 1Z [ r T , However. I have changed my domic.~le to
Ist~est and Naune.d TN
and am and have been a bona fide resident of the State of Florida since ~ ~ day of
pLU V E !v`3E 12 ~ 19 1
J
- and I reside at ~ 'f N • L • l iP1 ~ ~ L b~ ~ (U t
(3treet aed Namber)
~Q R T S i- L.. V C°_ i~ ST . L UG I E County. Fbrsda.
icily) .
and this statement is to be taken as my decLration o! citizenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF !<OR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
X919 t~A~ 10 PN i~ 51 .
. ~ a ~?~pNE~C~Oao 0
POITRA~A.
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IkEi:tl~ ~RIFi~J '
443939
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
{
I FURTHER CE that I have no intention to return to my former domicile, and I intend to remain in
'k T U C I E .County.
l(~ty)
Florida. permanents; . !
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~1~••4tiDO~SP~S`•~`~? - 4/~~ALY~~ R
Gc~E COUNT(•4~0 (Name)
v2'~y F~ ~A/~C Lo i n~
(Addrea)
sworn to and subscribed before me this say of 1~D 12T S
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} A.D.19
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ROGER i TRAS. CLERK OF G IRGUI T COURT
ST~. LUG I E .COUNTY, FtOR A
BY :
EPUTY LERK
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