HomeMy WebLinkAbout1386 Declaration of Domicile and Citizenshi
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49'x'608
TO TI*E Q.EAH OF T~ CIItCtIIT OOURT. - .
ST. LUG I E ~OUNITY. ~,pg~A;
• Thb is my dselarat3on of Demic~e and Qitisem6ip is the. State a[ i!7o'idt that I am ~6 this day is aooordaoos. and io
- coniacmity with Section 222.17. Florida Statutes.
i
I was f
~ a 1ega1 resident oI ~ and I
~ ~ J,S~ lat,~ -
re:dea u ~1 ~ - He~aeer. I have changes ap aomie7e to
" 18tr~stadN~b~N - i
and am tad have been a boat Sde resident otthe State ctl!'lorida siaoe dsy of
1>i~ tad I:eaide at ~ .
18tnet na Nov.r)
ST. LUG 1 E Co~y.l`~a.
taa~
and this statement L to bs taken as ap dsdaratioa ai dtiaeaship, actual legal residence and domidls in the Stets d Florida.
- IF FOR THE PURPOSE OF ENROLLING IF fOR NC~lESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES2
190 Atli 27 Pty ~ I5
. F~LEO Rl+rcoaoEo
- - S ROGER POITRASA•
CLERK CIRCUIT COUR
49'7608
I F[JB1~ CERTII~'Y that I will at my local address whet the registration books reopen. tad eompb wits all
~ other regninmeats of a legal resident of this State.
~ -
I F'iJBTHER CEftTIF'Y that I have no intention to return tom former domiale, tad I intend to remain in ~ i
U G 1 E _ ~ty~ ~
tCityl i
- ,
Florida. permanenci; .
- i.
u y
1..~-- )
~v:
O.s
Sworn to and auh.eribea beioe+e me this aZ- day et -
.e.D.~Q_- Jo~iw Iyo9easenJ -
R~~h
ROGER P01 TRAS, CLERK OF CIRCUIT COC~2T
ST. LUG i E COUNTY, fLOR 1 OA . .
. - -
- - 8Y: . -
EPUTY LERK
. - ~
' X337 P~~~77 .
• ~~.IJ
ACA Form 7l•Y2
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