HomeMy WebLinkAbout1594 Declaration of Domicile and Citizenship
49'~'6'~3
TO THE CLERK OF THE CIItCUIT COURT.
ST. LUG 1 E ~T~v, ~~R~Ae
This h mT declaration of Domidle and t~ttiseaship in the. Stars os Florida that I am this daT is acaordaaos, and is
- eoafarmit~ with Section ?22.17. Florida Statutes.
I wu fo~.~ a legal resident of d lA tt K Q ~ ~ and I
(Ctt~l 18tsb)
resided at ~ ~ y R~ c ~ 12c~ - However. I have ehaoged mT domicils to _
IliaMt and NowDw)
and am aDd have been a bona fide resident of the State at F'brida since H ~ ~7 01 i
~0~ ~ ~ -19 , and I reside at 1 ~ o f
-fie ~f••~•~18en~.c sdNaeb.rl
~ - 17- rzt _ ST . LUG I E Count, Florida,
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and this statement is tabs taken as mT derLration ai dtisenship. actual legal residence and domieDs is the State a[ 1:7arida.
" IF FOR THE PURPOSE OF ENROLLING li FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NANESS
- ~~:a
- 1980 A!!G 28 AM 43
_ ~_r
FILEO Rt:G FECOaUt ll
SI.I.UCiE COUY1Y.FtA.
ROGER POITRAS
CLERK CtRCUtT COUR~
RECCRR :'F~I~IFG_
i
1 FURTHER CERTIFY that 1 wID register at mT local address when the registration books :+eopen. and oomph with all
other requinmeats of a legal resident at this State.
I FIJRT'I~R CERTII~'Y tbst I Gave Do intention to return to m~ former domic~e. and I intend to remain in
_ r _ ~ ,z1 . L v i. i E ~iOUDt~
_ _
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FlOrlda. permiDCD[Ij.
r1 C ~U_ r<r jy,
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r
Il-- ~t
~ /0 ~ 0 a+~~
-'w~-:>~
1Ad8e~l
Sworn to and snbs~ibed befae~e me this a g daT oI ,
•
RA(;ER P017RAS. CLERK OF CIRCUIT ~Otd2T
- ~
ST. LUG1E COUNTY, fLORtOA - ~
•
- _ EPUTY LERK~
URc~~ ~Q
- - - Bt1tIRJJ 1 PSGE~~A~- .
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