HomeMy WebLinkAbout2302. _
D~clarafiion of Domicile and Cifizenship ~
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S1i980
TO THE CI.ERK OF THE CIItCUIT COURT.
ST. LUC 1 E ppv~y. ~,p~A;
This is m~ decluation of DomieDe and GStiumhip io tbe State oi Florida that I am SiIng this da~ in aecordanoe. and in
confornnit~ w~itb Section 222.17. F7orida Statutes. '
I was lormerl~ s legal resident of ~`-+{-~~ d~ _~ ~/Le ~-~• f_/.• -~• i7` and I
l(:it~) lStat~)
resided at ~~- ~~-~-t'd~ ~~ ~,~ - However. I bave ebanged m,~ domie~7e to
(8t+~+t aod Nmabed
and am and :. ave been a bona fide resideat oi t~e SW,e oi Florida ainee ~ ~ t~- da~ ot
~-C~r~-4~d~ ,19~a - and I re~de at ~-~ ~ /u~ ~ -
aod N~unbar)
~~at.~'- ~c- .~°..~ u_ _ ST. Ll1G 1 Co~nt~. ~lorias,
~av~
and this sUtemeat is Lo be taken ~s m~ deelantioo of eitizenship. actud legal reaidence and domieile in tLe 3tat~e of Florida.
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" IF F'OR THE PURPOSE OF ENROLLING Ii fOR HOMESTEAD PURPOSESi
CNILOREN IN SCHOOL~ PIEASE STATE PLEASE CHECK: ~~
THEIR NAMESS
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SI.lUC1E CG~Y*y,Fta
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ROGER Pp~TR :S
CIERK Cf~CU1i CCU3~~ ~
, ~fCCFn 1': N;~~: ~ ~('
~ 511980
I FiJRTHER CERTIf'Y tbat I w~71 register at m~ local address when tbe registration bool~s reopen. and oompl,~ ~vit6 a11
other requirements Qi a kgal resident oi this State.
I FUR1'HER CERTII~'Y that I have no intcntion to return b m~ former domieile. and I intend to remain in ,
-'- 5 T, L U C 1 E . Coantj~
1(Stj1 .
F7orida. permaaenii;.
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' Sworn to and snbscribed beiore me this J~ da~ d N
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6 w`~ , A.D. la V ~•.
ROGER POIIRAS, CLERK OF GIRCUiT COt~2T .
ST. LUG I E COUNTY, FLOR 1 OA •
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BY: ~i2~~' .. '
~ UEPUTY I.LERK
~ ~ 8~1~( c7~5 PaGE~
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