HomeMy WebLinkAbout2299 4.a r ` y _ ~
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TO Z'I~ CLERK CFTHE CIRCUIT COURT. ~4~5
S~'. LUG 1 E COUNTY. FLORIDA:. .
4~is L aqy deeLration of DonoicDe and Citizenship to the State of Florida that I am filing this day in aocordanee. and is
_ eonfortait~ witb Section 222.17. Florida Statutes.
f
I was f
~ a kEal resident of 1 / 1 ~ SS L° n J „~[~s and I
ltxyi
resided at
However. I have changed ~nJ domie~e b
- I and Numbat) - .
and am and have bean a bons 5de resident of the State of Florida since 3 a day of s -
29~.~. and Ireside at - ~
• 1 and Nombad
ST, lUG 1 E CountJ, Florida.
- tG~l
sad this statement is b be taken as mJ declaration of citizenship, actual kgal residence and dotgicRe in the State of Fbrids.
If FOR THE PURPOSE Of ENROLLING If fOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOLS PLEASE STATE PLEASE CHECK:
THEIR NAMESS {
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1106 1l 11~ fQ 3D
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~1filIKC11~tNT tAURT . ~
R£COR9'~IE'Rti'tEQ
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I FURTHER CERTIFY that I wiZ( register at my Iocai address when the registration books reopen, and comply ~+-ith ED
other requirements of a legal resident of this State.
' I FURTHER that I have no -intention to return b my former domiule, and I intend to remain in
- - _ T. U C i E CountJ. -
- ~Crtyl
I'lo;-ida, permanenti~. - - - -
(Name)
~ (A
S;. om to a.d subsrnbed before me this ~ day of _ZQ i r o
4 .
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Rn~ER PO t AS,-, CLERK OF C f RCUt T COURT - ".~c-
ST. LUG I E COUNTY, FLOR 1 DA - '2 r~`- s
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- EPUT LERK r
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