HomeMy WebLinkAbout0124 Declaration of Domicile and Cit~zensh~p
480529
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COUNTY. FLORIDA:
This is mT declaratioa of DomicDe and Citisenship in the State of Florida that I am 61ing this day in accordance. and in
conformity with Section 222.17. Florida Sta -
I was former a kgal resident of ~ . ~ ~ ` - '~'~fl~W ~i~.f'l~i~~r~ and I
_ ~ CIt (State)
resided at ~l However. I have changed my domicile to
(Stnst and NemD~rl
and an? and Dave been a bona fide resident of the State ot-Florida sinoel~~~~~ ~ daT ai
/ . ~ 19 `~C7 - and I reside at /t'/~., ~y.;El~J L.J
//~Z~ ~C" ST . LUG I E~ ~N~l
County. Florida.
IGb)
and this s4tement is to be takes as my declaration of eitiunsbip. actual kgal residence and domieRe in the State of Florida. '
- IF FOR THE PURPOSE OF ENROLLING IF";FO~1 HOMESTEAD PURPOSESi
CHILDREN IN SCH001.s PLEASE STATE Pt.EA!SE CHECK:
THEIR NAMESZ
i
--T- z.
. 1980 MAR 24 Alt i{~ 3 t
0.E1g1 CIROUi1~
ItiONte VERtFJ[O.M_
- - ~~a~ .
I FIJRR'HER CERTIFY that I wt11 register at my ]Deal address when the registration books reopen, and comply with all
other requirements of : kgal resident of this State. -
I FURTI~R CER1'fFR that I have no intention to return to m~ former domicile. and I iatend to remain in
U C 1 E _ County
]aryl .
Florida. permanenti; .
,,,,tt p .
f~. -
i r
Sworn to and subscribed before me this day of ~„~f lll_'if f-~~ i~5
:2~
~/_-fir .G~ ~ . A.D.1
ROGER P01 TRAS. CLERK OF C I RCU 1 T COt~2 T
ST. COUNTY, fLOR10A
BY: ~ ~ -
~ 1 t_,
EPUTY I.ERK
6tll
K Jr~O PdGE ~ .
+fn Fnrm 7l 22