HomeMy WebLinkAbout0977 _ y2 ~ - - -
Deciaration of Domicile and C~~~zensh~p
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700 THE CLERK OFTHE CIItC[l1T COURT.
S~~ LUG 1 E COVr>1~r.1-LpRIDA;
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~ `,'l13S is deelaratio~ ei Domidie and G7tiaeasbip is the Stag e[ Florida that I am ~i this dq is aooordanoe. and b
. _ oontormitj with Seetioo 2>~.17, Florida Statutes.
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I was f a legal resident d sad I
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resided at ~ 1/~~~5~~/d ' - Aowevet. I bava cDanded mT domicsle to
f8ta.~t ass
_ and am and leave bees a bona 5de resideat of the State dFlorida since ~ ~ d
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1l~.. sad I reside at `c°
~d ~(i~X~/P
cea..t a.a x~.el
- ST. L11G 1 E Florida,
and this statement is to 1x taken as ap declaration d dtisensbip, actual legal residence and domia'Ie in the State d Florida.
~i FOR THE PURPOSE Oi ENROLLING li FOR HOMESTEAD PUR SES~
CHILDREN IN SCHOOL~~PLEASE STATE PLEASE CHECK:
THEIR NAMES:
Q
~9i9 A'; ~ 28 A!1 ~ 3?
- y~Ct»00 VERif IED
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I FURTHER CERTII''7C that I w~ register at m7 loch addrns when the registration books reopen, and oomph with aD
other regnitementa o[a legal resided at this State. - - - - _ -
I F[JRTAER t~tiTII''Y thst I have no iateation to return to m7 former domin'le. and I intend to remain is
T U C E Conntj,
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Fbnda, permaneml~ .
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sworn to and sobea~"bed before me this ~ ~ dad at ~ G
• .79
~ ROGER POI TRAS. CLERK OF CIRCUIT GOURT ~i~~`~`u't-~~ty~~+ ` ~ • ~ f
ST. LUG 1 E COUNTY, FLOR 1 W1 _ ;
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