HomeMy WebLinkAbout2739 .t c-.c~~l~~i~..~E.11 !:1!t_.~~t1~~It~I~G-' ~El~! ~t~t~:~. ~~S~~t~~
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'FO THE CLERK OF THE CIRCUIT COURT. ~ -
S'~. LUG 1 E COUNTY, ;'IARIDA:
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This. is my declaration of Domicile and Citizenship in the State of Florida that I am fling this day io aecordanoe. and io
conformity with SeeGoa 222.17, Florida Statutes.-
- i was formerlt a legal resident oaf _ ~ n i CI~~T oL. _ and I ,
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resided at ~~b ~_._-r ~ C~ a ~Od ~ U~°. ' = Ho.oever. I have changed my domiule b
( sad Numlw) q(,h '
and am and have been a bona 5de resident of the Stale of Florida since . ~ nay
~ n i
- 19~ and I reside at ~ ~ ~ ~ ~ /e {
(9tred and Nambar) -
-f'e7 72~' ~ • ~ u L' r e• _ ST . L l1G I E County. Florida. ~ .
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• and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHI_~REN IN SCHOOL, PLEASE STAtE PLEASE CHECK:
THEIR NANESS
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- ~ .919 SUS ,YD P!t 2 33
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~~'ttFRIftEO '
I FURTHER CERTIFY that I wi71 register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State. '
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I FURTHER CERTIFY that I have no intention to return to my former domic~e, and I intend to remain in
~ z ~ U C I E County.
(City)
Florida. permaaenti~.
•ame)
pZ 7 ~ C~YYL L.C~ /
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$c~orn to and svb -'bed before vie this o~ ~ dny of
t,itiiiiiiatt:lj:i j• ' h• r
f~QGER _f'n TRAS, CLERK OF C iRGUi T COURT
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ST. LUG 1 E COUNTY, f LOR t OA - - ' ~ °
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• E YY LERK J '•`~t ' J_ _
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