HomeMy WebLinkAbout1710 - ~
4~i8380
i
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E Cp~vTy, FLORIDA:
This is my declaration of Domicile and Citiseaship in the State of Florida that I am ~8 this day in accordance. and in
conformity with Section 222.17 Florida Statutes.
I was formerly a legal resident of ~6=- /Y~w Yoi~~ and I i
. ((qty) (state)
resided at -Z 3,Sf~ I3 L~Sr ~,yf'°~~ ~ °~~4'r - . However. I have changed tray domieik to
(Strut and Nvmbacl
and am aad bave been a bona fide rsaidegt of the State of Florida aintx ~g day of
oGrca~ f~; , lg__L_.. and I reside at ~ 1` .S.C . ,Df'(/9 r 'T~~ ~'1~°~J.'> ,
(Btraat a'd NomMcl
;U~l ~ • ~ - ~ vc,F- ST. LUG 1 E County. Florida.
«yl - ,
and this statement is to be taken as my declaration of citizenship. actual kgal residence and domita7e in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHIt.OREN tN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
~..UED
fREO ah~ ti fLA.
St.l'~~~~. - ~ ~S
- CtE. j` ~ . il.'q I
- RECCF' ~ ~ ~~3~
OEC 5 21~ p!~ ~
- ~~i8380
i
I FURTHER CERTIFY that I will regvter at my local address when the registration books reopen. and comply with aU ,
other requirements of a legal resident of this State. - -
I FURTHER CERTIFY that I have no intention to return tom former domiu7e. and I intend to remain in
U C 1 E County,
'ty)
Florida. permaaenti; . -
1
` r/
tL -
- V ~ ~ 0 ~ i
,Hama) 1-~ ,
Srksrn to aad anbseribed before me this ~ day of S, 1~~ .S' / ~ U C ! ~ ~ - , '
- t ~P C _ _ A.D.19_ ~9
ROGER P01 TRAS, CLERK OF CIRCUIT COURT
ST . L UG I E COUNTY, f LOR t o
BY: ~
EP TY t.ERK _
nk 'y ,
~09K PaGE ~ ,