HomeMy WebLinkAbout1046 . '•j.
• ~ r tion of Domicile and Citizenshi •
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lb THE CLERK OF THE CIIiCU1T OOUAT. ~
S~~:~ LUG 1 E OOUN'1'X. FLORIDA:
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~ Ttlii is ~ deCiarati0a at Domicile and ~i Lblai~l~ ~II Za10 Stile ~ F)0~'Idi that ~ a~ ~tO~j ~ oa, io sabia'.'~w.r.• ~II
_ eoafarmiq~ with Section 22>:.IT. Flaeida Statutes.
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I was f a bgal resident ei
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resided at ~ v ~ ,f - Howews. I haw changed mT domicile b
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and sm sad bsw been a bona fide resident as the State od Fbrida since ~ ~ d
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~ ~ - Iif~. and I reside at L ~9 S. E". `.~~.e ~ 7~.
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ST. lUC 1 E C~4.
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snd this statement b to be taken as aqy dstLrstion oI dtiseasbip, adnsl legal residence and domidle is the State d Florida.
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IF fOR THE PURPOSE OF ENROLLING 1f POR HOMESTEAD PURPOSESs i
CHILDREN IN SCHOOLS PLEASE STATE PLEASE CHECKt
THEIR NAMES:
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.~1~~ ~1 tic ~ i~n~ c~FNNiN ors' ~ 1919 AUG I 0 Ak ~ 54
ppItRAS
CLERK CIRCUIT
RECORD YERIf1E0
454548.
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I F[TRTHER CERTIF'l~ that I wID register at mp tool address when the registration boob reopen, snd oomplf with all
other regniremeats d a legal resident of this State.
I FURTHER CERTlI~'Y that I bane no intention to return to m7? former domic~e. sad I intend to remsia in
U C 1 E Coaatj.
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Fbrida. permsnead;
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Sworn to and sobsen'bed before me this ~ ~ daT of ~ . L~ G.2.1,~
A.D.1!
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ROGER POI'IRAS~ CLERK OF CIRCUIT COURT
ST. LUG1E COUNTY, ftORtOA
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• EPUTY LERK
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