HomeMy WebLinkAbout0750 "i
Declaration of Domicile and Citizenship -
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49"x"243
TO Tli>; CL.ERR OF THE CIRCUIT COURT,
ST. LUG I E COUNTY, FIARIDA:
This ~ my declaration of Domic7e and Citizenship in the State d Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
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I was formerly a legal resident d ~l~ ~E'~N and I
I tCYty) IStatd
resided at ~ ~ y h A [~O~,e~ L A ~P/ _ However. I ve changed my domieale to
ISa..t aad Namb~r) 31..~
and am and have been a bona fide reaident dthe State dFlorida since~y~y -day d
~ _ ,19.5. and I reside at 6 ~ ~/r~ P( !D !/PJ
n IStrMt aad Nmb~r)
ZZ~~ r --f F ~ ST. tUG i E County. Florida.
caty)
and this statement is to be taken as my declaration d citizenship, actual legal residence and domide in the State d Florida.
IF FOR THE P-URPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CH.ECKL
THEIR NAMES:
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- ,r 49'243
11980 AUG 2S PN 2~ 3S
FaEO ~rrt? I:~cwtoco
Y S R~ER
POIT Y S~
CLERK CIRCUIT C T
RCC~RDYERTFtfO____~~~'
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I FURTHER CERTII~'Y that I w~71 register at my local addras when the registration boob reopen. and comply with all
other requirements d a legal resident of this State. - -
I FtJRTfIER CERTIFY that I have m intention to return tom former domiede, and I intend to remain in
U C 1 E .County.
Florida. permanenu; . ~ ICtty) -
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~ Sworn to and subsrn'bed before me this S~ dsy d
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ROGER POITRAS. CLERK OF GIRGUtT COtdRT ~ ~
ST. lE COUNTY, FLORiOA ~ ~
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