HomeMy WebLinkAbout0938 Declaration of Domicile and Citizenship ~ i
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TO THE CLERK OF THE CDiCUIT COURT.
ST~. LUG 1 E COU~y, Fi.ORIDA: f
9'hi: is m3 dcelsrstian of Damidle snd L`Ftizeaship is the State of Florida that I sm ifliag this da= is ateordan4s, and ~
conlormk7 wltb Section 222.17, Florida Statutes.
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- I was !o~ a legal resident d ~ ~ and I
II~t71 l8~
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resided at 8 Aorwever. I hays changed m7 domicils to ~
8t~t and NneD.r) ~ z
and am and have been a bona fde resident dtbe State dFbrida since ~7 d
~ f o7 ~.19 and I reside at
~ least ud Noml.el
Pdi~ ST ,'L~icte ST . LUG 1 E ~ti,
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and this statement b b be taken as m7 declaration d dtiunship. actual legal residence and domiale in the State d Florida.
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IF fOR THE PURPOSE OF ENROLLING Ii iOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES.
f1L1:0 /yID Wi4lt.8
ST.L_
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RECORD VER1FlED ~
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I F[JRTIiER CERT'iF'Y tbst I wdl register at mT local address when the registration books reopen, and oomplT with aD
other requirements d a kgal resident d this State.
I FIJRTAF.R CERTIFY that I have no intention to return to mT loaner domide. and I intend to remain in
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Florida. permanend;
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refit T~,e,
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Sworn to and sobsvibed before me this ~ daT d ~T ST l-k n~~~~
A.D.19: : ~ -
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R C R A CLERK OF CIRCUIT COURT •,i:~~ti"'"~+~~.~ ~ '
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ST. L UG I E OUNTY, f LOR t OA - ~
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