HomeMy WebLinkAbout0126 D~cl~rafi~~ ~f D~r~icil~ ~~d ~i~i~c~~i1i~
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This is my declaration of Domic.~7e sad Citizenship in the State of Florida that I am filing this day is accordance. and in
conformity with Section 222.17. Florida Statutes.
I w as fortnerll a legal resident of 'JS-YY1~ ~ I ! ~ and I
n ICit7) (Slats)
resided at _ ~~L~J.~~~~ Aowever. I have changed my domic~7e to
ISt:cat sad Nameat)
sad am and have been a bona fide resident of the State of Florida since ''I~~0.eC.. ~~I_~~~__,_ day d
_ 19- _ and I reside at ~
3) ~ n~ . S ~ .
_c~~1~P~• , .
(Std aadNambar)
ST. LUG 1 E County. Florida,
l(Styl
sad this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: 1~'-' ~-'1
THEIR N A M E S S~--~---~~
ter r
= 19~ KAR 10 PH i2~ 46
RE RSA.
_ OOUit
Gtr
. 4"7878'7
I FURTHER CERTII~'Y that I wII1 register at my local address when the registration books reopen, and comply with aD
other requirements of a legal resident of this State.
I FURTHER CER1'Il`'Y that I have no intention to return to my former domicile. and I intend to remain in
T . tl t 1 E ~ County.
((Xity)
Florida. permaaentl; .
! ~ % ,
':~~~:.~f ~ a3/3 /~"?iSSI SSi f'P~ l7~lP
~i0h?Y, -
/ 0 IAddeea~
Sworn to sad subsm'bed before me this day. of _
~7 a/~-c-~ , A.D.14~.~ ~lA c e ~ . CaR~R e ~e
ROGER POITRAS. CLERK OF GIRGUI T COt~2T
ST. lUG1E COUNTY, FLORIDA -
BY:
_ EPUTY LERK ~ ~7 ;ems
• b0o~~r~ ` P1.GE ~:~V .