HomeMy WebLinkAbout1198 ~ Declaration of Domicile and Citizensh~i ~
P
~93~'7
TO THE CI.ERK OF THE CI~iCU1T COURT. ~
~T. LijL i E oOUNTY. FLOAIDA: ,
Z1~s b mp deelaratjon ot Domkik and Cltirenship in tbe State of F{orida Wat I am 51ina t1~Is da~ in aooordaaos. and is
aonionnit~ ~vit6 Saetion 222.17. F7orida Statutes.
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~ I was forrner a kgal resident of l A/~„~r- ni r r~ FyR ~iQ~ ~P~ ~~t'R _S e~ ~ I
1(~ityl 19tat~1
resided at ~~~~~~~'•°A~~ ~A~P~ _ f'_ - However. I bave ehanged m~ domk~e to
1&rNt ~od N~b~
aad sm aad have been a bona Sde resident ot tLe StaLe of Florids sinee ~ da~ d
19~. and I reside:t ~.~~r L~~-~ s~` t'/=' r%itic! ~
(8t:.~t ~d Namb~r)
~ ~ c.! r i c' _ ST . L UG I E Connt~. F~orida.
((~f4) ~
and this statement is to ba ta]~en as m~ dec]antion of eitiunahip, actual kgal residence and domidk in tbs State d Flo~ids.
If POR THE PURPOSE OP ENROLLING IF FOR HOMESTEAD PURPOSES~
CHILDREN IN SCHOOL~ PLEASE STATE P~EASE CHECKt ~
THEIR NAMES:
_;~:.Q11dL-~.! n ~ S . ~~ir1 ~ s~~L,-~~'
•--T~/~7P 5 GL~'~~iAn~ //~n~__n_S~_`/
T ~
.l Gf~ /~Wm n S~ v
~.,r9 27 :l~ i ~
F~3lT ~K tc1:~R'ut 4
Si.?UC~F CGL~KTY.F~:S.
~'..R Pc~TRaS
ti.£T.X CdRCt;tT COli
- R:C•''a3 \._a,~.~~ ~
~ Y~~~
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i I F'[JR1'~iER CERTIFY that I w~71 register at my loeal address when tbe ngistration booics reopen. and oompl~ with all
~ otber requinmeats o[ a kgal nsident of this S4te.
I
~ I FURTHER CERTI~R that I have no intention to return to m former domia7e. and I intend Lo remain in
t_ T. U C i E Co~nty.
~ tCA~) ' T
~ Fbrida. Permanenti; .
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U~ t` . . ;L'..i
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~ s ~ .r~a,r~ ~ti,~ D~,~~s~~
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r ~~/F ~GU'+~ ~ ~ (Alam~1
~ /~5 ,C.~ ,~~,q S e_
a ~ ~ndde...)
~ Sw aad snbsenbed before me this ~ da~ of T ~ J T. ,L ur. e.~/~. ~ 33 S/S.~
r _
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~ `-t A.D.19_ -
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K A C ERK OF GIRGUIT GOl~2T
. . .
ST. LUGIE COUNTY, FLOR~oA
• .
~ BY:'
; EPUTY IERK .
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~ ~ annr 311 •DACE ~1~ /