HomeMy WebLinkAbout0113 ..L.'...-,i,...a•L:~.+~~ ~"s~otaV~~<I G..~{`l~~ ~~•lt.~~iZ.~.,i_.
~F ti~.'708
TO THE CLERK OF THE CIRCUIT COURT.
ST . LUG 1 E COU~y, ~,O~A;
Thu islay declaration of Domicile and Citizenship in the State of Florida that I ain fling this day in accordante. and in
conformity with Section 222.17. Florida Statutes. _
C-
I .vas formed a kgal resident of - ~.5-~ - and I
~ 1 (State)
resided at ~ E= ~1~~~ - However. I have changed my domiet~e to
(Street and Number)
and am and have beta a bona 5de resident of the State of Floorida since ~ ~ C`~ day os
19_____. and I reside at J1 ~ ~ ~~~~~L1
1 (8treat asd Nambarl
~ C. _ ST. LUG I E ~ County. Florida,
(City)
and this atatemeat is to be taken s, my declaration of r5tisenship. actual kgal residence and domiet~e in the Stan of Fbrida.
li POR THE PURPOSE OF ENROI.I.ING 11= i:OR HOMESTEAD PURi+OSESs
CHIIDREH IN SCHOOI.s PLEASE STATE PLEASE CHECKS
THEIR NAMESS
i
" '~T9 oCT -8 i2~ 07
itLEG iNC ri ~ur.~Eu
. ~ S ROGER
PO TRaSa~
CLERK CtRCJIT CGCj~
.461.'708
-
I I FURTHER CERTIFY that I wt~l register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in
T. U C I E .County.
icily)
Florida, permanentl;. '
- ~
c-~
X603 S~e~No Qd .
S.vorn to and subsrn-bed before me this nay of
c.~ob-~~ .~.D.19; 7 j ~ C PR;s~~ /1A Dwy e~ -
ROGER POI TRAS. CLERK OF CIRCUIT COURT
v
ST. LUG 1 E COUNTY f tOR 1 OA ° ' _ _
~C_• ~
_ EPUTY L
n ~ ~
a+»x3~PaGE_ ~1•,