HomeMy WebLinkAbout1872 .y
Declaration of Domicile and Citizenstii
P
4'~~?s
TO TI;E CLERK OF THE CIItCUIT COURT.
St. LUG 1 E COUNTY. glpg~A; -
This L m1 declaration of i~omiri3e and~:~ ~ 3ata ai F'er;•.~a •.!:~-t I ~ ~++a t~• d.! in.~,eoeriaoee. and In
ooniormitT with Section 2.17. Fbrida Sbtntes.. - .
I was nner a legal reeidaat of ~~N V / l/~ _ ~ /,5 sad I
1 leteW
resided at ~ V` However. I have changed ~ domio'le to _
(St~et-
and amend have been a bona fide resident of the 8tats of Florida since ~ ~ dsy of
s, F.
Of G .19 and I reside at / 934- - /?!O'i~N//Ug5/ ,0~ ,B~ Il p .
{8ttwt aed Na+elMe!
pO~i r" S T ~ UG ST. LUG t E Coati. F~~ .
coal _
and this statement b to be taken as aqT declaration of titiseaship. adnal legal reaidenee and doeoidle is the State ai Florida.
. IF FOR THE PURPOSE OP ENROLLING If FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOIs PLEASE STATE PLEASE CHECK:
THEIR NAMES:
• RNN~STFS cT /(~F~~
- - -1980 JAN t I A!I ~ t 6
- ~
` : t 0 AtICO PE•T7.fSLA.
GRIwiT COURT .
- - 1lltllit0 VERIFIED ~
• Y I ~ V
I FURTHER CERTIFY that I w81 register at my kcal address when the registration books reopen, and oomplp with all
other regnirements of a legal resident of this State.
I FIJR1'l~ CERTIFY that I have no intention to return tom former domicile. sod I inter to amain in
t ~ L~~-! ~---r-• U C 1 E . CountT.
Florida. permanend~
.
~?:~t:uti%t1
a ;i
~ ' ,
O • „
I ~ i ~ ti
~ • . . f ~ S~i (Name) -
ia'•••••;~••~ ~ p
^ ' S • • ' ~ before me-this day of / a/~ ~ ~T ~ (~G ~ E 33 'y.5 ~
A.D.19 V~ -
P01 AS RK OF CIRGUI T COt~2T
ST. LUG I E COUNTY, f lOR A
BY: C .
- EPUTY LERK
~11~3 ~~~.863
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