HomeMy WebLinkAbout1612 Declaration of Domicile and Citizenship ~ ~
soz~83
TO THE CLERK OF THE CIItCUIT COURT. ~ .
ST . LUG 1 E CpU~y, ~,O~p:
This is m7 declaration d DomieDe and Citi:eaship in the State d Florida that I am ~ this dq in aeoordaaoe:~aod is
ooniormit~ with Section 222.17. Fbrida Statutes. -
I was former a kgal resident of ~~~ti 7~it/ - /r/~C~l aaa I
resided at c3.2'~ 1/S~ ~l~'.~/~/~ ~/!/L~`l - However. I havelehaaged m~ domin7e to
18tewt asd I~omb~r)
Ti's
and am and have been a bona Sde resident d the State opt Florida since ~ ~ dad d
-19~ and I reside at ZZ ~~A~OCl3~
18a..c asd Nvbar!
LGlC/E ST. LUG i E ~ti,~~a,
IW) - .
and this statement is to be taten ss mT deeLratioa d eitisemhi~. actual legal residence and domia7e is the State d Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKL
THEIR NAMESt
I°50 OCT -9 PN 2~ 34
i
~li£C GhC ~ECGi+uI D
_ `r - SLlUC1E COU!I1Y.fl:..
ROGER POITRAS
CLERK C13!'UIT C~L3~ -
_ ~ 502883 t
i
. ;
t
II I FIJRTIiER CERTIFY that I w~71 register at mT lonl address when the registration books nopea. and oompiT with an .
other regniremenL d a kgal resident d this State.
i
~ I t I ve no ' to return tom former domiak. and I Mead to remain in ~
t E Conntl.
` _ ICk~! _ -
Florida. permanenu; . -
• 4_
~i:. A ! r z
S-
- i~t n ~
u c t~,,,,,~~~ ~S i L (~t~
G~T L ~35cs`~-
-
~ ~ tbitl~ wbeertbed before me this dad d G .
. , r, c fi- -
. A.D.1
ROGER PO I TRAS. CLERK OF G i RCU I T COt~2 T
ST. LUG I E COUNTY, f LOR t OA ~ - -
' -
- - BY: s
EPUTY LERK
-
~34~ p~i~i2 -
- - _