HomeMy WebLinkAbout0712 ~
Declaration of Domicile and Citizenshi ~
. p ~
~9o~s .
TO THE CLERK OF THE CIRCUTf OOURT.
ST. LUG 1 E ppU~y. ~,p~A:
7'his is m~ declantion oi Domie7e and Citiunship ia the State of Fiorida tlut I am Sling this da~ in aeoordanoe. and in
eonformit~ witA Seetion 222.17. Florida Statutes.
I was formerly s kgal resident of _ ~~,,ef,~._ ~~~~,~,g t and I
.
_ ~G5ty1 l.ce!
residcd at Z ,~~,1~ Sf.~ . Ho~?ever. I have ebanged m~ domicile to
18treet and Number)
and am and have been s bona fide reaident oi tl~e State of Florids sinee ds~ a[
t~~~ .19~q
- and I naide at ~A~/ fY~v
" ( ~•~t aod Namb.:)
.~vrr ~ Sf, 11~~l1'~ , ST. LUG I E count~. Flor;da.
1At~1
and ttis staLement is to be taken as my declarstion of eitiun~hip. aetual kgal re~idence and domic7e in tbe Stste of Florids.
I~ FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES~
CHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THEIR NAMES:
!919 JUN 25 AI~ [ 9
FILEO AKO PECUKUEU
ST.LUCIf COU!1TY.FLA.
ROGER POITRA
CLERK CiRCli1T CCUfj3
~r~:~ Y~ ^.";Cf 1.~.--~~~
F:
4490ZG
I FURTHER CERTIF'Y that I w~71 register at my local address when the registrution boolcs reopen, and compl~ ~vith ill
~ other requinments of a kgil resideat of t6i~ Statt.
I
~ I FURTHER CERTIFY that I have no intention to retura to my former domica'le. and I intend to remain in
T. U G I E ~~ty.
i
~
~ Florid:. Permanenti,: ~
~
~
~ .
~ . ~ ~oU~r~, _ .
~ ~j'' . , C~o
~ :G
~ . ~ ~ ' ~
~ t~'• ' Y / ~ .
~ _ L~, %~~~i ~it
y .
~ ,
< "
~ f ~l/~
~
~ tN,m~) T
` ~C .C~~~ . ~o~~ vl
~ IA~)
E Sw~orn to and snbscn'bed before me this ~ ~
~ ~ - day of _ ~~n f P F~~
_ V li~~, . A.D. i9_ • 3 3 ys Z.- -
.79 _
ROGER POITRAS. CLERK OF GIRCUIT COI~tT
;
F . .
~ ST. LUG I E GOUNTY, f LOR 1 OA -
~ ~ ~ • . .
~ BY'
EPUTY ~ERK '
. 80GK31i P~E 711 ~
# ~