HomeMy WebLinkAbout1392 Declaration of Domicile and Citizenship ~ ~
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495 786
TO THE CLERK OF THE CIIU'[JIT OOURT.
ST. LUG I E ppU~q. ~,p~~;
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This is mF deeLratioo d Domicale and ~tiseashi~p in the &att d 1!lorida that I as this daps aoo~edasce. and ii
eonformit~ with Section ?22.17. h7orida Statntaa. .
I was fonaerl a legal resident d and I
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resided :t a ~e~ 1 S `7 _ Ho+re.es. I hsee ehasSed ss~ domiole to
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and am and have been a boas Sde eesident d the State d Florida sis+oc dal d
Q -19~,, and I reside at ~ tMx F'~w ~1 ~M~ .
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°~,~.L•!y ~il o _ ST. LUG 1 E
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and this statement is to betaken as nr) declaratiao d dtiaemhip. aetaal lesal residence and dosiole a the She d Fl~arida.
IF FOR THE PURPOSE OF ENRO<.LING IF FOR NOMESTEAD ?URPOSES~
CH I <.OREN I N SCHOOL, PLEASE STATE PLEASE CNECIC:
THEIR NAMES:
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49S'786
I FURTHER CERTIFY that I will register at m~ joeal address when the registrstioo books reopen. and cmpiF wish a1!
other regniremems d a kgv reaideat d this State.
~ I FLTRTFIER CER1'g'Y thst I have no inteatioo to retara to my former domio7e. acid I intend to remain m
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f Florida. permaneau; .
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Swam to and snb+aibed before me this / / daT d ySe7 `
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ROGER POI TRAS. CLERK OF C IRGUI T COt~2T
ST. LUG I E COUNTY, FLOR t DA ~ - - -
EPUTY LERK ~ -
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