HomeMy WebLinkAbout1099 Declaration of Domicile and ~itiienship
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TO THE CLERK OF THE CIRCUIT COURT.
S T . LUG ! E COUNgy~ FLORIDA:
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This is my declaration of Domia7s and Citisenship is the State of F'ldrida flat I am Sling this day in aooordanoe. and in
conformity with Section ?12.17. Fbrida Statut-es~. ~ J
I was former a legal resident of ' ~ ~ v e r_ ~ t V ~ ~ S r rv . ff ~ I
1 ((~tyl ~ (9tstd
resided at ~ ~ V 9' ~ ~C ~ ~t 7 ~ t ~ However. I have changed my domia7e to
~ a~N~? ~ .
and am nand have been a bona Sde resident of the State of Fbrida siaoe ~ ~ y 19' 7 c day of
'M) t u3? . 28~.. sAd I raside at ~ 0 S ~ 2 0 0 /G1. ~ N P ~ C.
(Stmt asd Nnmbr)
~
% - ? C ~ e ST . LUG 1 E County. F7~ida.
((xty) .
and this statement is to be taken as my declaration of citiaenship. actual legal reaidenoe and domiei7e in the State of F{orida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES f
CHILDREN IN SCHOOLr PLEASE .STATE PLEASE CHECKS
TH IR NAMES:
2 J 1 ~(~CI ~ '
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I FURTHER CERTIFY that I w~11 register at my local address when the ngistratioa books reopen. and eoaipty with all
other regairements of a legal resident of this State.
I FURTHER ~ CERTIFY that I have no intention to return tom former doavede. and I intend to remain in
U C 1 E County,
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Florida. permaneau; .
1980 A;Bz -8 JW 4 7
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