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Declar~.~:~:. ~an~icii~ area Citizenshi
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4~i8814
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COZJNTY, FLORIDA:
This is aq declaration of Douiiciie and Citisenship is the State of F•brida that I am Sling this dad in aoeordanos. and in
conformity with Section 222.17. Florida Statutes.
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I was formerl a legal resident of ~R 1 e kTb C~ i ) 1v • ~ and I
lCipl 18tatd
resided at ~QEGO N Iq V ~ ~ _ However. I have changed m7 domicile to
18traat asd Numbar?
and am and have been a bona fde resident of the State of Florida aince Z~ daY ~
N ~ . .19 [ -1 - and I reside at 4 ~ ~ ~ ' ~~''4 ~1 S A ~1 G -
IShwt and N~br)
~6RT ~
? ~ C ~ C~ _ ST . LUG I E County. Florida.
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and this statement is to be taken as my declaration of eitiunship. utual legal residence and domia'le in the State o[ Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, ~
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: ~ i
THEIR NANES:
~ NCR t~ ~
as N N V` - ~ FLED ANL' ~ SUED
f ROLE%"' ~-t$ t
-~QN IIIR C.. ~ CLERr ' ~;,URT `
_ _ RECOa^ l= psi '=n,_
Doc 1 2 34 PM 'i~
4'b8814
I FURTHER CERTIFY that I wr71 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 thst I have no intention to return to my fob
r~ do_eik. and I intend to remain in
JT . t_ u c 1 E ,County.
~ ICrty)
Florida. permanents; .
t;
~ Ito ~ / ~ `fore ae this day of CS'R-T ~ uc~ ~ `
;
- ROGER P01 TRAS. CLERK OF C IRGUt T COURT
6
ST. UGIE COUNTY, FLORIDA
BY: ''Y~ C vt C
EPUTY t.ERK
a~321 P~~2~3~8 -
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