HomeMy WebLinkAbout0569 Declaration of Domicile ..and Citizenship ~v
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TO THE CLERK OF TAE CIIICUIT OOURT. .
ST. LUC 1 E Cpv~y, glp~A;
This is ~ declaration d DomiciM and (~tiseaship is the. State d >~7ocida the I aan IDiaa this dq is aooordanes. sod it
• coatamit~ wltb Section 222.1T. >~7orida Statutes. '
Iwo: ~alegalseiidentd 1~~. I7~f
h : , 1' l U r,.01f9 aadl
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reaided at Howeer. I have ehaopd m~ domirHe to
IBq~st d M~MrI - -
aad am aodhave been a bans fde resided d the state d Florida sinoi hl~? ~ ut r 1 / ~ d
. .
~ 19~.. and I reside at ~z ~ o ~ ~~F arj~
ST. LUG 1 E Coaat7.p'1ao'ids.
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and this statement is to bs taken as mP dee]aratioo d dtiaemhip. actual lesal reeideaos and domieHs in the State d Florida.
• IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CMECKS~
THEIR NAMES: ~ `
" r. ~My C Q
• • ~ ~1?0 SEP w V
- ~ FtlEO F~CGROED
• S tX1E CWNIIYY.FLA. ~ -
s ~ER POITRAS
tl:ESll CIEtt:U1T C T
AFCpR(; l'fRt~tfG-
498'796
. .
I FURTHER CERTII~'Y that I wiII resister at mP local address when the reKistratiot+ books reopen. and with all
other requirements d a kgai neidsnt d this State.
I FURTHER CERTIFY that Z have . no intention to return tom former domir1'k. and I intend to remain in
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Florida. permaneati; .
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a .o
c~F CCUNI`I
~z~4 Qan 'e ~o~,d
. ~ ,
` ul?ii.al
- swam to and sab.eilbed beioee me this ~ dq d Gt. i l ~C ICIa. 3~ t/ 5"0
~ - _ _
ROGER POI TRAS, CLERK OF C 1 RCUI T COtd2T
ST.-LUG1E COUNTY, fLOR1OA
-
EPUTY LERK
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s 1r~f1I P~ ~
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• iG0 Form 71 22