HomeMy WebLinkAbout1680 Declaration of Domicile and Citizenshi y~
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458'75
TO THE CLERK OF THE CIRCUTI COURT.
ST. LUG I E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship is the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of C~oLU1YlR/A ~ _S~uTN C'HiE~'UniR and I
ICityl 13tatel
resided at _ /S/4 .SENATE ~STii'EF_ T NAT However. I have changed my domic.~7e to
(Street and Number)
and am and have been a bona fide resident of the State of Florida since S~ yp day of
.TAn/ VARY -1919
- and I reside at _t 4 ~d SE yE~ST~5Fi91'EN l'1 LE
(3treet sad Number)
~OK'T 6r L yc i E ST . LUG 1 E County. Florida,
lCit71
and this statement is to be taken as my dedaration of citizenship. actual legal residence and domict7e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
19791":+'29 ANii~24
FIlEO ANO NECOkpEO
S R~GER
POITRASA~
CiERK CIRCOIT CO~~~--
.riECQRO YERiffft?.~
4458'75
I FURTHER CERTIFIt 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 -
F I FURTHER CERTIFY that I h:ve no intention to return to my former domicile, and I intend to remain in
T. U C I E ,County,
i (~7)
Florida, permanents; .
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d/ ~ ~a Eo?~:, mat
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tNam.~
/490 6E G'EsT/~AUEN C~/.f'CLE
(Addrsal
Sworn to and subsrnbed before me this ~ day of %~U,PT ~ST• L ~Je FL ~3~~z
A.D.19_ ~1 .
ROGER POI TR S, CLERK OF CIRCUIT COURT
r
ST. LUG I E COUNTY, f LOR A
- :
EPUTY LERK
s~~K 3U9 oa~~ 16~
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