HomeMy WebLinkAbout2120 ~~~tara~ior~ of ~a~r~~~:c~~ ~~a
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TO THE GI.~'ItR OF THE CIRCUIT COURT, -
ST. LUG 1 E OOUN'i'Y. FLORIDA: - _
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Tftis~isln,T d'eetaratioa d Domicile and Citisenshtp is the State d Florida that I ain lilinE this dp in aocordaaoe. and is
e+ooformib wNh Settim 222.17. Z•7orida Statutes. -
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I wet loaner a Legal resident a[ J O~-° l
~ • / V~ 1N andI
lCt4l - (etattl
resided d 2 Oo ~ GV
EST IDBTH ~T,QE~~' Soweves. I have changed aopr domicSs to -
tses..e.ea Nemb.el -
_ and am and have been a bens fide resident d the State d Florida since dy d
' , ~pfE~BE~2 , i~,?2. andI reside at ~ I !~~lyGD Lt/Ei~ STie.F~ j'
pta+..~t..aHm.~.rl
/`~A2T ST `UG/ E ~ ST. LUG i E
~c~l
and this slateme~ is to be ta)<en as mT deeLntion d dtisenship. actual legal residence and domia7e is-the State d Florida.
IF-FOR THE .PURPOSE OF ENROLLING IF F_OR HOMESYEAD PURPOSES
CHILDREN IN SCHOOLs-PLEASE STATE _ PLEASE CHECK:
THEIR NAMES: _
~Y~L YN ~w~DA _ ~ }
~3i9 OCj ~-2 P~ 12 22
- ~ STRC4UGIE~TY. SA. -
- CLERK CIRdAT
l~CORD VERIFICO
- 461053
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I Ft)RTHER CER1'1FY that I wt11 register at m~ local address when the registration boob reopen. and oomplT with all
other re9nixments d a legal resided ad this State.
I FURTHER CER1'1F'Y that I have ~ intention to r+etnrn to m7 former domia'Ie, and I intend to rtmain in
u c Co~ntJ.
lae~)
Florida, permsnead;. ~o,2r S T G U c /F
~0 UNly
q~ ,o
r
_ £ CCUNSV • ~ '
• - ABJC7A~L /9~ //n/~t~.9
K~ u?da=...~
Swam t~o and sube~'bed before me this dsT d 02T S7`- ~ (/~I ~
79
ROGER PO i TRAS. CLERK OF C i RCU 1 T COURT ~
ST. LUG 1 E GOU_NTY, f LOR 1 DA _
BY: -
EPUTY LERK
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