HomeMy WebLinkAbout2706 TO TH£ CLERK OF THE CIRCUIT COURT. ~ e~ r~
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ST: LUG 1 E COUNTY. I~-L,ORIDA; .
• .
This is uq declaration of Domic9e and Citiunsbip in the State o! Florida that I am Sting this day in seoordanee. and is
_ conformit,~ wills Section 222.17. Florida SLtutes.
I was lormerl a kgal resident of 7,~~ N t • way`O~ ~ 1?7 /}II/~9 and j
resided at - However, I have changed my domicile b
ISteeet Nnmb~ -
and am and have been a bona Sde resident olibe Stale olFlorida since 'r ~ day o!
J ~ ~ 19~ and I res2de at U ~ Q ~ ~
(Strut . nmberl
~ ~ ~ }-•L~Q ~ ST. LUG i E County, Florida, . j
(t~tj) -
and this statement is to be taken as my declaration of citizenship. actual ]egal residence and domiale in the State of Florida.
I F f
OR THE PURPOSE OF ENROLL 1 NG I F' FOR HOMESTEAD PURPOSES a
CHILDREN IN SCHOOt.~ PLEASE STATE PLEASE CHECKS {
7HE tR NANESS _ ~ . ~
~ ~~~?y`
- E.
P~-tt~i n. ; . rid ~ ~ ;
- .
t
~oaw~la~e-.----~ -
1 FURTHER CERTIFY that 1 wall 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 intention to return to my former domieslt, and I intend to remain is
T. U C I E _ County.
- tC~t~l
Flarida, permanenLt;.
• ,SvE ~ALLA21~,
(Name)
(Address)
rn to and subscribed before me this dny of ~C ~ , V ~i~.y~ p
79 • -
r~OCER POI TRAS. CLERK OF G IRGUI T COURT ,tillKlsl:fijtj~ii~ ~ a,
ST. LUG I E COUNTY, f LOR 1 DA : '~J;
•~~oit& v;,~ f '
t~ I i _ w - s r
.