HomeMy WebLinkAbout1822 i.. ,
d~ciaraton ~ o~ Domicile and Li•iizenship
' 455050
710 T>~ CLERK OF THB CDtCUIT COURT.
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S~~. LUC i E OOUNZ'Y. FLORIDA: "
~ `'r6is is aq~ dedaratioo d Domidle and C~ is the State d Florida that I am SiinB this dq is aooordana. and b
oonformi4 wits Sietioa 22~.1T. P7orida Statute:.
~ ~erll~Gkd aedt
r- I was i~ a kEal resident d ~ e < ld n _
IClt~t (st.W
resided at g Cd~~ / A~wents. I tune ehanaad mT domic7e to
(s~.var.~ ~ - -
and am and love been a bona Gde resident d the State d 1!7orida since - f~/ ~ dal d
eJ S 19 ~ and I reside at ~le ~ /I ~ %Jf~hD C/i''G 1~
(Str+.t aa/ I~IavD~rt
P111'
~ •S/. L yGi•L° _ ST. LUC 1 E Co~mtT. Florida. .
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and this statement is to be taken as ~ deelantioa d citizenship. actual kcal residence and domio'Ie in the State d Florida.
IF FOR THE PURPOSE OP ENROt.t.iNG Ii FOR HOMESTEAD PURPOSES
CHiIDRER IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: / _
1919 Ali I S J~f i~ 39
sir
it~c~
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aERI(c(RCtnT couRr ~
RECORD VERIFIED
- ~ 4550~~!
~ I FURTHER CERTIFY that I.wi>t seaister at m~ loin address when the registrsi3on books reopen, and oomplT with aD
other requirements of a lesal resident d this State.
r
I FURTHER CE'dtTl>:'Y that I lure no intention to return to mF former domicile. and I intend to remain in
JT . L_ UC I E . Couat~.
~ _ (ait~)
F7orids. permanend;.
e o/` ~v~ dwo -
sworn to and:nb:~ea before me this / aa, d ~c'~' T S LdG - ~l
y . 3 3 S/ s~ ~
R A CLERK OF CIRCUIT GOURT .~'s;:~'r'•"~~u~. ~.i,
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ST. LtJG i E COUNTY, f LOR 1 OA - ' " `4~
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