HomeMy WebLinkAbout0372F~~c~arafiQn ofi DomicEl~ ar~d Ci~i~~~~I~ip ~-
5~.262'7
TO THE CL.F.RK OF THE CIRCUIT COURT.
ST. LUG I E Cp~7~tTy, FI,pRIDA;
This is my declaration oi Domic~e and G~tiuaship in the State of Florida that I am fling this dsy in ar.cord~nce. and in
coaformit~ a~tb Sectioa 222.17. Florida Statutes. ~
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I was formerl~ a legal resident oi ~. f~C'.• )~~:) S~,''~ , •"~ %/`~ and I
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resided at ~~~~ ~w~ /~~~ ~~ F' ~~ - However. I have e~anged my domic7e to
(Strcet aod I~~ber) .
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and am and ha~ e been a bona fide resident of tbe State oi Florida sinee •?~ ~t ~~•' ~Z ~~ __ day ot
11~ -19~r~ andIresideat '~ ~1.~~ jc ~i~)c1~~;(~i~ ~~'~~3~ .., ~1-~~-------
.y < (Strcri aad humbary t
~~ -/~~c' ~'~ F' ST. Ll1G i E~ Co~cy. ~~,?~a.
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and this statement is to be taken as my declaradon of citiunship. actual legal residence and domita7e ia the State ai Florida.
" I F fOR THE PURPOSE OP ENROLL ING
CHILDREN IN SCHOOI~ PI.EASE STATE
THEiR NAMES:
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IF FOR HOHESTEAD PURPOSf.S~ -
PLEASE CHECK2 ~
1961 J~~1 -7 ; :: ~ ~`~
"~ t~ e~t ~- coa. t~
SL l Uf.if f"J:~ ~`~ f lb.
ftCGER OITR~S
CiE~K Ct:?i,l'•~i Ciw=K~ ~
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~1_262'~
I~'UftT'~~R CERTII~'Y that I wn7l register at my loca) address when the registration books reopea, a~~ compS~ wi:~ ~a
other requirements of a legal resident of this State.
I FURT'f~~ CER-Tff'Y thtt I have no intention to return to my lormer domic~7e. and I intend La remain ia
-'--- ;- 5 T, L U C 1 E ~~~~,
((St7) _ -
Florida, permanenti~.
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'C:c_%'/~~)~ ~Gili~lt~~L
!(Name? /
~ ~/~ L~.i~~a c~:~'.Ic1 :~~~rE
(Addresa)
SR orn to and subscn'bed before me this ~ da~ of t~' ~~C % C..k
~ ~.D. _ / 98/
ROGER P011RAS~ CLERK OF C tRCUI T CO~fi2T
PrNN ~ r t)
~ ST. LUG 1 E COUNTY, f LOR 1 OA •
~ BY: ~y~,~,LGe.t y • .
(~~~ ~EPUTY (.LERK
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