HomeMy WebLinkAbout2941 . - ~ - c _
a T}iE CLERK QF?}iE CIRCUIT COURT, -
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_ __S'~, 1. UG 1 E covrrr]r, l`"LOR.IDA:
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nis is my declaration of Domicile and G~tiLeaship in the State of Florida that I am Sling this daJ in accordance. and is '
_ co~fonnity R-itb Section 722.17, Florida Statutes.
y I w u formerl• a Ipga] resident of ~ y S ~r e ~ _ - ~ Q- Q t and I
_ IG~tT) ISw.d
rr s ided at ~ \ ~e \IJ o o a C 0 ~ ~ L k ~ h'1 o'~q> Iio~revec. I have cbaaged my domic~7e to
(Sttee! a,d NumLer)
z n d ~ and have bran a bona fide resident of the Sta4 of Florida since \ S ~ day d
- _ ~ sT1~__ _...19 tiG
- aad I reside at ~ o~ ~ a w? S ~ ~ a~? 3
Isssret >aa x~t.~
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~ : e. ~ c ~ - F- ~ o . ~ ST . L UG I E County, Florida,
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and tt•.is statement is to be tfkea rs my declaration of citizenship. actual ]egal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CNECK:
THEIR NAHES.
SaSo n F • ~.e ~i~
455~Z
- 1919 AUG 2 I - P~ 2~ 43
- sal
- - ~ - CLERK CIRCUIT CDURT
- RECORD VERIFIED
I :-li;; i i? R Cam::-IIr'Y that I ti:a register ~t r-:y loca : ddr<ss ~-nc~n the registration hooks reopen. and comply r.•ah all
c-r rc qui,
er.,ents of a legal resident of this State.
I
r
j I ~~.'RTHER CR-.'RTIF'Y=thathave no intxotion to return to my loaner domic~e. and I intend to remain in
- ,_r _ . T . l_ U C 1 E County,
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couNTy~
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rsne)
f
(Address)
...3 s ,•L• :r~•:d brier r:,e tt}-v-s - day of _ ~ 0~. a~ ~~o d - - a 1. ~r -1^QOt~
- ~i..~-__,. A.D.19_ C~ - - -
. ~1 A Ti ~1; 2A y tl E~4T /U ~1N ~I ¢~~2
~ ~ ' ~2 f=nl- ?!+S fl_Fr2tC f)F CIRCUIT COL:2T ~
T . 1_ UG 1 E COUidlY, F L.D:i Z - -
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