HomeMy WebLinkAbout0324 Deciaration of Domicile and Citizenshi ~f ~
P
.4~502`7
TO THE CLERK OF THE CIRCUIT COURT. '
ST. LUG I E CoUtv'~'x. F1.ORIDA: ,
This is my declaration of Domicile and Citiunship in the State ot Florida that I am filing this day in acoordaace. and in
conformity with Sectioa 222.1T. Florida Statutes.
I was formerly a legal resident of _1~~' ~.S' f~~'w /G'~ and I
ICit~l 13ta1e1
resided at ~~-'~~1 nc, T.~ ~ ~-C . However. I have changed my domicile to
(Strcet aad Num~er)
and am and have beea a bona fide resident of the SLte of Florida aince /YI RR C'~7 f ~ 9 ll day of
/'Y'_an~h .19~.~., and I reside at ~~3 ~QASh ~ ti ~ r
~s~.oa N~~~
~p Q t ~T c• i~ , ST . L UG I E Count~. Florida,
IGyt~1
and this stalement is to be taken as my declaration oi citizenship, actual legal re~idence and domicile in the SUte oi Florida.
I~ FOR THE PURPOSE OF ENROLLING Ii' ~OR HOMESTEAD PURPOSES~
CHIIDREN IN SCHOOL~ P~EASE STATE PLEASE CHECKt ~
THEIR NAMES:
~ ~t~r .Si,~d,~ ~
;~?9 : 21 PN ~2~ 03
t~l.i.L' J?NU FlGUiiucU
s ADGER
POIrRAS A.
4EwIS LIRCUQ
Dl1RJL
~ F.~CQ?~ Y[?t'r~~^- ~
44502'7
I FURTHER CERTIF'Y that I will register at my local addre~~ when the registration books reopea, and comply with all
; other requirements of a legal resident of this State.
~
1 FURTHER CERTIFY that I have no intention to return to my lormer domicile, and I intend to remain in
, T. U C I E . County.
E lCit~) . ~
~ Florida. permanen~i,.
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~ (Name)
~ ~`i' ~~~c H S,d P,L C_ T
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~ Sworn to and subscnbed before me this day of ~G R T S l. L L~ C f~
" / ~ ~ A.D. 19_ '
~ . 79 -
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~ ROGER PO I TRASs GLERK OF C I RCU I T COt~2T
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~ ST. LtJG 1 E COUNTY, FLOR 1 OA
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~ B Y : ~
~ EPUTV LERK '
~ ~o~K 309 324 ~ .
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