HomeMy WebLinkAbout1758 Declaration of Domicile and Citizenship
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TO THE CLERK OF TAE CIItCU1T OOURT.
ST. LUG 1 E apv~y, gl,O~pA;
This b np declaration d DomkiM and t~iti~osnship Ia the State of Plaids that I am ~ thb dq is aeeor+danee. sad is
ooafaranitr with Section 225.17. Florida Statutes.
I was t~ a legal reddsnt d and I
lAyl ItMaW
resided at However. I have ebanged aqr domidle to
ltlteMt ssi Nr~i~r1
sad sm and bave been a bona fide resident d the State dFlorida since - - y . _ - dq d
• 15~. and I rssiae at ,L~f - ~ ___!cr/~,f T' ~y Q--r~.R..
.,.~ti ~c ST. LUG I E~~ ~
Connt~. Florida
1Ct41
sad this statement is to be fates as ra~? deeLratiw? d eitiseaship. sdwl lesal residence and domicils is the State d Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN iN SCHOOL, PLEASE STATE PLEASE CHECK2
THEIR NAMES:
r
I FURTHER CERTIFY that I wiU register at mT ioai address when the r+sgistratioa bodrs reopen. end eomplT with all
Other e+equirements d a legal resident d fhb State.
I FvRTIiER C'ER1ZF'Y that I bave m intention to return tom former domie~'ie. and I intend to remain in
U 1 E , Conntj.
- ICtt71 -
Florida, permanenci;. ar1~}~2os
1960 SEP 29 PM I~ 02
FILEL' ANC F~COROCO
- ~ . SLLUCtE COUNTY.FI A.
-,,.:i~:??:u~~~ - ROGER t'OITRAS
3 U q~~~i • ~ CLERK CIRCWT C :lRT
y ; ~
• Sworn to and ''i~nbseribed before me this ~ dar o[
- - A.D.1.
ROGER POITRAS, CLERK OF CIRCUIT CO~tT
ST UG I E COUNTY, ftOR 10 -
- _ .EPUTY LERK 600K~ P~GE11t7~ -
.
- -
J ~
-.;i"
- AGO Fcrm 71.22
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