HomeMy WebLinkAbout0808Declaration of Domicile and Citizenship `~~
' 509303
TO THE CLERK OF THE CIItCUIT OOURT.
ST. LUC 1 E COU~y, ~,O~A:
This b ay dee4ration d Domicile and Citiseaship in the State d Florida that I am Slim this dq is aooordanos. and in
eonlarmi41 with Section 222.17. Florida Statutes.
I was fo~ a kgal resident d ~; ,_YY~~ • and I
ICtg1 IlitsW
resided at ~ -~ . ~~ 3 I ~ x - However. I have changed ~ domicile to
(8tiwt aad Nsobsd
and am aad bave been a bona Sde resident d the State d Florida since ~ aJ - ~ /S ~ ~~ n~ ~ - dq d
IJ ~ y • ~ .19 J and I reside at S ~ ~ S ~'`L ~ ~~ ~ Q ~ 3"l 0 Z R. ~ ~ < ~~ .x..
_ lBt~Mt..aNo~Dw) '
`.~~- ~,~,a,c . ~ .~~ . _ ST. lUG I E Count. Florida.
labs •
and this stateme~ is to be taken as mT declaration d citizenship. actual legal residence and domie0e is the State d Florida.
" I F fOR THE PURPOSE Of E~NROtt ING
CHILDREN IN SCHOOL, PLEASE STATE
THEIR NANESS
1 rim w--ti t\o~~ i .. ~~ a-
F FOR MOME~STEAO ?t1RPOSE3~ "
PLEASE CHECKS
1980 DEC -4 A14 1~ 23
FILED aflD~R~CO~hOiC~O
S RR PpTRAS~•
CLERK tIRCU1T j/~
509303
I FURTHER CERTIFY that I will register at mT local address whea the registration boob reopen, and eomP}T with aD
other requieuments d a legal reaide~ d then State.
I FURTHER CERTIFY that I have ao intention to return to m~ former domieek. and I intend to remain is
=--., - - - ~ ~ . a. v ~ 1 E . Co1mt~.
ICit71 _
Florida. permanents; -
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~ : c~ ~ .~
~~. ~ `+ 3~ 1.Z ~~~no ~na.J-D r ``~v~.c~ \p~i/r
Swann to and subsQibed before me this daj d r~ ~' ~ . ~ < < ~ '~
• ~ ti-- . A.D. i~1.3~3~.~ %~o se , CH RR o / I . -
ROGER POITRAS. CLERK OF G IRCUI T COC~tT ~~ ~~vM
ST. LUG i E GOUN77, fLOR 1 OA -
- - BY: C~t~-~
~ EPUTY LERK
.~~
.. .~
-344 P~ SOS ~~ • . _
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A(;!1 Fnrm 77 ~22 ~
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