HomeMy WebLinkAbout1090 • ~
, ~ c~ ~3~n-ricii~ snd Citizens~i ~ ~
De C
4~i'7968
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC 1 E OOUI+ITY. FLORIDA:
This is my declaration of Ibmieiie and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
/ E r.--
I was formed a legal resident of /{'C~e7N f i t-~ 4: o G ~ , ~ ~ w ~C"t S / and I
ICityl 1&atel
resided at - ~ ~ ~n . However, I have changed my domicile to
tBtrMt aad Humt~r)
and am snd have been a bona fide resident of the State of Fbrida since day of
,~~='C . _ 19?
~ . and I reside at d C iV Ni•~~L3c- c /~L ~ a
~ ~ t3w~t asd Nnmb~r)
` i cue c c` C c7 %
. c.-~i~ !/ice ci/~c~ ST . L UC (E County, Florida.
~Cttyl
aad this statement is to be taken as my declaration of citizenship. actual legal residence and domitDe in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: ~
fiit.EY i.~Jlti
_ ROCS. ~ " . :S
_ RECORf 1: ~a _ ~
~c 3 2 06 PMT.'
4+~'~968 ~
~ I FURTHER CERTIFY that I wdl register at my loea! 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 tom former domicile. and I intend to remain in
~ T. L U G I L COUnty.
i
(City) .
Florida. permanensi; .
_ • I ,'a. ? Lht,Qst. eft v
.J .
- ~ . = lip" l~~l?~ /.~~~z(_
r e ~ AdBrw!
Sworn to and `sn~itribed before me this ~ day of
~ ~ c ~ - A.D.19_
R ER P01 TRA C ERK F C IRGU1 T COURT
ST. IE COUNTY, FLOR OA
EPUTY LERK -