HomeMy WebLinkAbout0489 Declaration of Domicile and Citizenship `F
498'746
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ST. LUG 1 E OOUNTY. FLORIDA: ~ •
This b mT declaration of Domkile and C~eaship is the. &ate ol~7oeida that I sat lUios this dq is aooordaaoe. sad is
• eontccmai4 with 8eetioa I~8.17. Florida $t/atntee. .
I was i me a h3sai resident at y ~ /y - _ ~r/QL ~ asd I
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resided at ~ T /1~01~i ~ _ 8owee~. I have eha~ed mT domiele to
tetra.ad rlesihal ~ -
and am and have been a bona Sde reaideot a[the State d)<7ocida since a dq aI
1S~,,Z, and I
r.aiide at 9o~s ~ P~ S/M/~ y T ~t ~ ~
~D IQ ~ ~C`'~' ST. LUG I E
r.ec.riti..l.rl ~.F'loeida.
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and this statement is to be tales as ~ dsc7aratioa of eitisenship. actual lsaal reeidsne~ and domielfe is the at Florida.
• if FOR THE PURPOSE OF ENROLLING If FOR NOMESTEAO PURPOSES, .
CNILOREN IN SCNOOt., PLEASE STATE PLEASE CNECK:
THEIR NAMES:
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19~ SEP -9 AM il~ 44
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aQG~ER
PO
TRASA.
CLEiq( CIRg1t140URT
- 498'746
I FURTSEIi (~RTII~'n that I wm resister at aqT hxal address when the
I other rego;remente oi' a issal reaide~ d this State. 0° boob reopen, and aompi,~ with aD
I F[JRT~Ii C@iT1T'Y that I have no intention to return tom former domia'le. and I inwnd to remain is
' UCIE .~7.
~ Florida, permaaenti;
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b Ca[e"T1'
ac a
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- Sworntoandsnb.eiibed beiioee m. this dq of ~~2~ ~Lc C~ 1 +
. A.n. .
ROGER POITRAS. CLERK OF CIRCUIT COt~2T -
ST. LUG I E COUNTY, FLOR 1 OA J _ .
• • ~ A -
EPUTY t.ERK
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~ OR~ PAGE ~ ' , . ~
Ar0 Form i1.'2.'~
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