HomeMy WebLinkAbout2004~ t -
Declarafion of Domicile and Cifiizenship ~
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TO THE CL~ERK OF THE CIRCUIT COURT.
ST. LUC 1 E ppv~y. ~,p~w;
511800
Tbis is m~ decluation oi Domic~e and Citiua~hip in tbe State of Florida that I am fltag this ds~ in aooordaoce. and ta
oonformit~ ~eith Section 222.17. Florids Statutes. '
''e ~~~ere ' ~ •
X wu formerl~ a legal resident ot `•S~ r=eo 1_a i.'~t•~ ~~r,~ ~ I
. lGtit71 lSt+t~
resided at ~ 13 ~r~ o3v R oa r~ Aowever ~ave ebanged m,~ domiu7e to
(8aeet.ad N~mb~
and am and have been a bona Sde nsident of tbe State of Florida ainoe ~'~ ' da~ a[
,19~~andIr~deat ~.-.,-.=~~ ~ _,_~~-15 Kachina Lane_ n~~.t_ j~,tcie
(Stiert aad Numbcl
_ ST . L l1G I E ~~. ~ri~
tc~~
and this statement is to be taken as m~ deeluation o. itiuns}up. sctud 1ega1 re~idenoe and domicile ia the State d Florida.
" IF FOR THE PURPOSE OP ENROLLING IF iOR HOMESTEAD PURPOSES~ ~
CHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THEIR NAMES:
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- 1980 OEC 29 PM 2 53 ~.
`~ Fr~En ~xc F~co~n:o ~
st ~uc~r ceuNt r.r t a.
C~ER!( C AC~~T CCLRt
_ ' REC~:~~> >.: a,: ~t : ._ ~~ I
;
511800
I FIJR1'HER CERTII~R that I wn'D register at m~ loc~l addrea~ ~+hen tbe registnRion boob reopen. and oompl~ witb aII
other reqniremeab oS a legal resident oi tbis State.
I FURTHER CERTII~'Y that I have no intention to retnrn to m~ lormer domie~e. and I lntend to remain in ~
~'-~ ST* LUGIE ,~y.
lCk~) .
F7orida, permaneat~~.
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ROGER P01 TRAS* CLERK OF G IRGUI T COC~2T ~~ ~`~ ~ o~~eK, 1
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ST. UG 1 E COUNTY, f LOR 1 OA •
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BY: ~ _ '1
, P TY RK
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~ BOOK345 PaGE2~ ~~
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