HomeMy WebLinkAbout0618t?~cl~~~afion ofi ~on~icil~ and Ci~i~:~nsf~ip
• 51.2'763
TO THE CLERK OF THE CIRCUTT COURT.
ST. LUG 1 E ~pUt~ry. ~t,pRIDA;
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This is my declaratioa oi Domic7e and Gtiiizenship in the Stats of Florida that I am fling this day in acoordanca. and in
conformit~ witb Settioa 222.17. Florida Ststutes. ~
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I w•as tormerl a 1e resident oi , ' and I
/0 lur= r'/~?o.Pr ~ ~c~,~ ~sw,.~
resided at K~~ v~ , Hoa ever. I have cbanged my domic~7e to
(Stre~et a~d Nmaber)
and am and have been a bona fide resident of tbe State of Florida since ~~ ~~ day oi
~~~~E ~- ~ c~' 19~ d- tnd I seside at ~~S? ~/~ G~ S Q ~ L.. U.~ ,.
(SUe~rt.nd Numbv)
,~p~ ~ Sr` o~ ~~. F' ST. LIJG 1 E " Count~. Florida.
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and this statement u to be taken as my declaratioa of citizeaship. actual legal residence and domic7e in the State of Florida.
" IF FOR THE PURPOSE OP ENROILING
CHILOREN IN SCHOOL~ PI.EASE STATE
THEtR NAMES:
r-
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I FURTHER CER1~'Y that I R-~71 regisier at my loca] address v~hen the registration books reopen, and eomply wit6 aD
o:her requiremenb of a legal resident of this State. -
I FI7RTHER CERTIF'Y thst I have no int~ntion to return to my former domie7e. and I intend to reauun in
- -~ 5 T* L U C 1 E ' , CountJ.
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F'lorida. permanenci;.
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Sworo to and aubsrn'bed before me thi~ ~~ da~ ot
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ROGE P01 TRAS* CLERK OF C I RGUI T~Otfi2T
ST. LUG 1 E COUNTY, f LOR 1 DA -
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BY:~ Ij~,~.~c~~ axn
. EPUTY LERK
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I F F'OR HONESTEAD PURPOSES~
PLEASE CHECK: ~/
1981 JkN -8 Il~ !~ 58
FIL~f RhC F= CORnf'J
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