HomeMy WebLinkAbout1106 Declaration of Domicile and Citizenship
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TO THE CLERR OF THE CIItCIJ1T OOURT.
ST. LUG 1 E aptly. ~,p~pA;
This is nqT declaration oI Domio7e lad (~tiseaship in tbs State of Florida fiat I am ~ this daT is aooordaaoe. and in
aodonmitT wltb Section 222.17. Florid/a';3~tatutee. /J
I was fo~ s bgal resideat d _ Y'n in ni Q n n . ~.C. e~t,~.~ e~ ~ I
(i~t71 ~ (&wl
resided st ~D Ir o e ~ LJ ~ ~ ?P ~7; ~ Y~ 3 - Sowever. I Gave changed mT domia'le to
- (8trs~t yd Nm~r)
and am and have bees a bona Ede rasidant of the State dFlorida ainoe ~ ~ daF d
.14~1'2~ and I reside at -3 (o G Q~t~+~.-~.~
. (8er..t oA I~Isba)
ST. LUG I E Conat7.Florid~
(ab~ "
and this statement is to be tatea as n~ declaration d eltisenship. actual legal residenos and domie~e is the Bute d Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHfLOREN IN SCHOOIs PLEASE STATE PLEASE CHECKS
THEIR NAMESS
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Si.LI~CIE COllH7Y.F``A.
i~~ RnG£RPCtITRAS
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02543
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I FURTHER CERTIFY flat I wr11 register at m7 local address when the registration books reopen. and aomplj with ap
other regniremeats of a legal t~esident d this State. -
I -CER1'IF'Y I ha na mention to ret~a to former domin7e. and I intend to remain is j
" J u c ~ E Conag
Florida. permanenci; .
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Etngrs~o a baloro ms this daT of _ . ~ ~ ~.f a-
- R~ER PO 1 TRAS. CLERK OF C 1 RCU 1 T COt~tT '
ST. LUG I E COUNTY, f LOR OA - -
BY: CC • , ,
EPUTY LERK '
V
- 3~0 P,~1106 - .
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~~n Forn: ?2
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