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HomeMy WebLinkAbout2375 - Declaration o~ Domicile and Li~~~-~n~~~i~ ~ 45'72'75 ~ '!00 THE (~~RK OF TAE CII~CUIT COURT. . ST-. LUG 1 E COUNTY, FLORIDA: • • `:This is mF deelaratian o[ Domidk a~ Citiaeaahip In the State d 1:7osida that I am 51iaS this da,~ is acoordanae. and is _ oonformitT with Section 2?2.17, >`7orida Statutes. _ . .r I was a legal resident d ~iqn~ c ~ O and I . 171 IStaNi resided st ~ SLR c o L l~ w ~?.t_ - Aowever, I have changed ap domieijs to 18traat and Nam~bad . and am and have been a bona Sde resident d the State d l`7oridasins T daT d mac'„ T_ ~ -19 ~9 - and I reside at •~30 ~ S /~T,ac.Qiyr G Ni~?/c.:rrt y 18tr.atand d~/c.~c r ST. LUG I E ConntJ.Florids. ICI • and this statement is to be taken as mT declaration of dtizensbip. actual legal residence and domicile in the State d Florida. ii FOR THE PURPOSE OF ENROLLING IF FOR HOHESTEAO PURPOSES, CHIIOREN IN SCHOOL, PLEASE STATE PLEASE CHECK: rj~/1 THEJR HAMES: ~ ~ I ~4t/Y~ i4LL~.~ e~ca....~z ~~PiN t/~ ~-/7iQ/.~77i? r /Ciln~ets~rr.~tit _ M~e _~rp 'C +y ~ I ~ s~~Ei c" ~P°~"ai~~~°n. c~RCwT ~j~j,,~ ~~j . REt~01l0 VfRiFIEO..~~CL~~ 45'72'75 I FvATHEIt CERTIFY that I w~71 register at m7 Local address when the registration books reopen. and oomplT with all ~ other requirements d a legal resident d this State. I I F[]IiTI~R CERTIFY flat I have no intention to return to mF former domide. and I intend to remain in T U C E Connt~, f - a / ~ - F7orida. permanead;. ; =cow J. =v } C`J ~h '••::t ,536 ~ ~S_ `cd ~ ~g~~~,r' J r Swors t0 and snbsa7~bed before me this ~ did d /"p T ~ c.r C c ~ . w.n.19 ; ~1 ~ ~ ~ ~ - t ROGER POITRAS. CLERK OF CIRCUIT COURT ~ • ~ ' ST. LUG 1 E COUNTY, FiOR 1 OJ1 _ - . - . BY: -E~-~ - • EPUTY t.ERK • ' Bo ~5 PacE~70` . ~