HomeMy WebLinkAbout1669 Declaration of Domicile and L~~~i~~:nship
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4645 4
'i~0 THE CLERK OF THE CIRCUIT COURT.
S~.. L UC 1 E CO~q~ ~,O~A; .
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~ 4'hit is my declaration of Domic~7e and Citizenship is the S4te of Florida that I am fling this day is aooorda.noe, and is
_ coaformitj witb Section 222.17. Florida Statutes.
I was formed a legal resident o! ~ and I
i - l (Stag
resided at However. I have changed ray domiule to
Ist,nt.ad I~~mber) ~
aad am d have been a bona fide resident of the State o1 Florida since ~ day o[ i
19L~~~ and beside at - - ,~~/_~r'
f (3trest and Nombal
ST. LUG ! E County. Florida,
1Cityl
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
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IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,?
CHILDREN IN SCNOOL~ PLEASE STATE PLEASE CHECK:
THEIR NAMES:
9 ~ - I r r.
ST.Lt;CiE COjNT Y.F LA.
RDG£R P~ITRAS
Q-fRK CI~CU`74C'J~~
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464594
I F'[JRTHER CERTIFY that I will register at my local address when the registration books reopen. and comply with all
other reQuirements eI a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic~e. and I intend to remain in
T. U C I E ~ County
Florida. permanentl;.
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Sworn to and sobsm'bed before me this / day of
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ROGER P01 TRAS. CEERK OF C IRGUI T GOURT _ ~ ~ . ~
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ST. LUG 1 E COUNTY, FLOR DA -
BY• '
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' EPUTY LERK '
B~
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