HomeMy WebLinkAbout2533 ~.~i~E.~~G~~'Cc.?c~?t t t.f~'ta~~E~~t~~ ~E1~~ ~..rii(f.:(t~51~~t
~0 THE CLERK OF THE CIRCUIT COURT.
S~. LUG 1 E COUNTY. FLORIDA: ,
This is ml declaration of Domicile and Citizenship in the State of Florida that I am filing this d,~l in accordance, and•is
conformitl with Section 22Z.1T, Florida Statutes.
I was formed a kgaI resident o[ ~ V
P
•h-t? Zt l~~ ~ ~ I
~}N-E s~f~tPptC'R1) tSuta) i
resided at U~_~!~~ ~,._._8e~a~lsaT~ - Aowever. I have changed ~ domicile to
IStreet and N~mober) _ #
and am and have been a irons Sde resident of the State of Florida since ...f" i ~S'j" 3 dal of
3tAc1~-retE 326
~G .19~ r.l ' andIresidea! ~y'dQ
S1ZUTH QCY~n J(ttuL°
~~'r'~j
e{~~ sT . Luc , e~~ and Norab4j ~nh•
and this statement is to be taken as ml declaration of citizenship, actual kgal resideau :red domicile is the Stage of Florida.
IF FOR THE PURPOSE OF ENROLLING If fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR MANES:
t~~'aQ~ C . Lovr~
s
~IC ~ . ~y
12oxA~+~ M ~ ~ 19T9 All6 20 AN ~ 5~
A~J~t1~ G . Low 7 _ p~
. ~ - i
6tltCUtT COURT
RECORD YERIFtEO._._~ 1
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intcation to return to my former domics7e. and I intend to remain is
^ - T . U C .1 E ~ - , Countl,
_ (Cic~)
c~lorida, permanently.
~ENQ~. ~ , Loves
INsmt)
24.00 SourH ~ctn 17. e,~rr
r IAddresa)
Sworn to and svbsrnbed before me this ~ 7~~ day of t'~~T'---~s.!'CE
ROGER PO i TRAS CLERK OF C i RCUI T LOURT •~~`~`~~~~~~~+~~~~~`~`p
ST. LUG 1 E COUNTY, f LOR t OA - ~
.,.•oa`~~~ ~;r = _ ~ _
i r. t O % ~
BY . _ ~ - _
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