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HomeMy WebLinkAbout1434 ~a Declaration of Domicile and Citizenship X9"7635 TO THE CLERK OF THE CII~CUIT COURT. i ST_ L UG 1 E COVtJ'1'Y. FLORIDA: This is m7 declaratioa d Domic~e and Citisenship in the State of Florida that I am filing leis daT is accordance, and is oontormit~ with Section 222.17. Florida Statutes. ` I was form~e~rl a kgd resident d S ~ and I x resided at ~~/'"JF~ d -However. I have changed m~ domicile to f 18trMt gad Number) and am gad have been a bona ifae resident of the State d l!7orida since a~ ~ dad d ; 19~. gad I wide at ~ ©QCl~/9/1D ~ ~ / tStr.~t sect Atomb.r) a% (,?C~Cj ~ ST. LUG I E ~ti. uxcil and this statement is to be taken as m~ declaration d eitiuaship. actual legal residue and domia7e in the State d Florida. IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES i CHILDREN IN SCHOOLS PLEASE STATE PLEASE CHECK: THEIR NAMES: Ant o ~ - 3 1930 ~u5 2T P~ ~ 02 - s+ E,,~~,,~,~~~ u~. - ~~R~~ CLERK CIRCUIT C J~_ fi~coro t•EEtlilEi'._ { 49'7635 ' I FURTHER CERTIFY that I will register at mT loch address when the registration boob reopen. gad oomph with all other regninments d a legal re:ide~ d this State. I FURTHER CER1'g'Y that I have m inteatioa to retarn tom former domicile. and I intend to remain in UCIE . Count7. ~ t6t~) ~ Florida. permanensi; • t f ' E _ i ~0 Uf; ie~ T: ~ . ~ _G~~ P ~1,,~~', ;t'~ ~ r . F rte. I{' ~ t (A~lfY) E S.vora to and subsen'bed before me this 7 aaT d /1 s Q-~Srw°~ . A.D.1 ~ r1 n~i ,N y RAv 0 - ROGER P01 TRAS. CLERK OF CIRCUIT COt~2T - . ST. L UG I E COUNTY, f LOR t DA ~ - ~ . - - BY: ~ EPUTY t.ERK ' . - . _ _ . AGn Form 71.E