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HomeMy WebLinkAbout1611 . • • • • ~ Declaration of Domicile and Citizenship 4'79Ei51 TO THE CLERK OF THE CIRCUIT COURT. ST. LUC 1 E COUNTY, FI,ORmA: This is m7 declaration of Domicile and Citizenship in the State of Florida that I am Sling this day in sccordanoe. and in conformity with Section 222.17. Fbrida Statutes. ,w,11 v I wu lormerl a legal resident of O o I I v ~ / O ~ ~ and I ICit,l Ilitde) resided at ~ 9 O 9 ~/~2- _ Aowev~j~'. I have changed my domide to 18terat aa+d Nnmbad ~-K., ' and am and have been a bona fide resident of the State of Florida since ~ - ~7 ~ 19~ - and I reside at °2 ©O f jOj f'~K WQO ~ ~ C //e . ' . (Straat sad Na~mbarl P ® R~ ~-T~ v c. ~ e. ST . LUG 1 E County. Florida. lavl and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile is the State of Florida. i f POR THE PURPOSE OF ENROLLING I F FOR HOMESTEAD PURPOSES CNILDREN IN SCHOOLa PLEASE STATE PLEASE CHECKS THEIR NAMESS ' VI?~oN~~A /CoCc/s~y•~~ _ ~ 11 e n ~o ~ ~ /s'v`~ ° 1960 t~AR 17 AK i = 0 I 8 ~E% v? ~ ~ /C o c /5 r9.~J t~ F~~ED~~ N ~~caeuEO p SROGER~POITRA~~ ' ~ ~ P. ~ L ~ pCG /519 C7 6lERK CIRCiNT COURT IIFCARi VERtF~O._~ 4'79651 I FURTHER CERTIFY that I w~71 register at my loin address when the registration books reopen. and comply with all other requirements of a legal resident of this State. I FURTHER ERTIFY that I have no intention to return tom former domicile. and I intend to remain in U C 1 E County. It +e~l _ Florida, permaneasl; . _ . ~ V I lY t" e-Jl[ ~l ~OC C / S~ (1X a V sworn to and subsen'be~~efore me this / 7 day of _ _ _ A.D.19~~ a _ ROGER P01 TRAS, CLERK OF C IRGUI T COC~2T ST. LUG I E COUNTY, f L.OR 1 OA ~ . BY: ca a ' EPUTY LERK . ' gWw~~ ••arn Fr.rrn 71 22