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Deciaration of Domicile aid - Citi~ensh~p . ~
~.4'7413~
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TO THE CLERK OF THE CIRCUIT COURT,
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ST. lUG I E COUNTf[. FLORmA: - -
This is aq? declaration ~t DomicDe and Citiseaship in tDs State of FiorWa that I am ~ ibis dty in soooa+danee. tnd is
ronfo:mit,7 with ~ectioo 228.17. b'forida Statutes. ~ j
. . I was f a legal resident of ~1 ~ (+V ~i4-/ le F!~ ~ - ~d ll~ ~ gad I
_ , card _ ~se:w
resided at B e-if -1 • Cf
Al~iw ~ ~ W ~ ~ - `'''y l J ~ - However. I Dave ebaagsd a~ dooaicDe to
cen..t..ar~.>~l -
and am gad Dave been a bona Bde se~ddent of tDs State otFbeida siuoe B d _ ds, d
- - -19- -aadIrasideit I~1~• LR/4'~S •E~'
retr..~..aH..e.~
ST, IUGiE -
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aad tDis statement is to be taken as ap declaration of dtiseasbip. aetnal kgat resideros gad domidb in tbs State ai Florida.
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IF-FOR THE PURPOSE OF ENROt.~iNG IP FOR 'HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: -
THElR NAME8S
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190 JAN 28 ~ ~ 09 • -
_ ~ aERac caa~r cauR
- - -4'7430
I FURTi~Ii CERTIFY that I wiII regst~er st mT local address when tDe ragistratioa books reopen. gad ooiopb witD aD
otDer regninments d a legal resident et tDis State. .
I F[JATHER CERTII~'ll- tb# I Dane no intention to return tv farmer domia7e, and I intend to remain in
U ~ E _ Como~tj.
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Swore to and subeen'bed before me ibis ~ O daT at _ -
ROGER PO~TRAS,. CLERK OF GlRGUI T CtNdtT - -
ST'. -LUG 1 E COUNTY, f LOR 1 OA
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