HomeMy WebLinkAbout0970 Declaration of Domicile and Citizenshi
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• 454498
7~0 THE CLERK OF TAE CIItCU1T WURT.
SAY LUC 1 E OOUNY7t. FLORIDA: ,
lfi.i M ~ ~i{iYW d i/V~IRA w~a VR~C41~~ ~ tAV fJMY~ d l lol~{i~ MME I am ~ WY d~~ iWf~W~o1 ~ ~ F
• _ vwiriiii iiiiii n ssa: ar-~~s-rte _a_ . i c rr -
- I was f~ alegal resident d t aad I
-1 ~ 1 18tatel
resided at _._.1.~ ~1 !9 /J~ lJ /~-e~Qj~~d,_ Rowever. I have e}ianged m~ domieDe Lu
l8t~st aai Na~Derl -
and am sad Aare bees a bona iiae resident dtbe State d.Flosida sins dq d
.~_.1l~,., and I reside at 9
~l/ e /q AP~ go 3
18tsMt rod NssaMrl
- l• c ~ w~ ~e Gc n,~~ ST. lUG 1 E c~,,,a. Fem. _ t
and this statement is to be taken as ap decLratio®d dtizensbip. adnat legsLrFsidenoe and domkiie in the State d Floeids.
IF iOR THE PURPOSE Oi ENROLLING IF. fOR HOMESTEAD PURPOSES,
CHILOREN•IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NANESS
~ ~~~9 ASE; !0 AN ~ 37
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S R
CLERK
~ RECCRO YEMFiEO
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454498
I FURTHER CERTIFY that I w~71 register at mY local addr+as when ebe registration boob reopen. and oomph with aD
other regniremeats d a legal resided d this State. -
I FURTHER CERTff7r that I have no intention to return to ioraxr domic:7e. and I intend to remain is
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Floods, Pyi. ~
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Sworn to and sabsen'bed before me this daF d L _ A/ ~P
ROGER POI TR/lS. CLERK OF CIRCUIT COURT
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ST. _ LUG 1 E COUNTY, FLOR 1 D~A _
BY: ,t%c~e~a -
_ EPUTY LERK
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