HomeMy WebLinkAbout1306Declaraiion of ~o~icile ar~d Cifi~~ns~ii~
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TO Tl~ CLERK OF THE CIRCUI'T COURT,
ST. LUG 1 E ~pv~ty, ~t,pRIDA: '
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This is my declaration of Domicae and GStizenship ~a the State oi Florids thst I am filing thu da~ in accordance. and ~u
coaformity with Seetioa 222.17. Florid~ Statutes. ~
I a•as formerl~ a 1ega1 resident oi ~~ e(~Q ~~ S ~~ P~P ~° and I
' l(1it~) ISeai~I
resided at _~~=1..1.~ ~ ~~ ~ . HoR ever. I bave changed my domic7e to
' (Stsset and Namba) -
and am snd have been a bona 5de resident of the State of Florida since ~e C• ~~ day of
,19. ~ ~ , and I reside at ~L'y ~ ~~Q - ~ ( ~ ~' Q
(Ste+ret and Numberl
~ n 2{- `~-~ - L~~~, _ ST , l UG i E Count~. Florids.
t(~it~)
and this statemeat is to be talcea as my declaration oi citizenship. actual 1ega1 residence and domicle in the Stat,e oi Florida.
" IF fOR THE PURPOSE~OF ENROLLING
CHILDREN IN SCHOOL~ PLEASE STATE
THEIR NANES:
IF iOR HOMESTEAO PURPOSESi ~
PLEASE CHECK:
~981 JaN t 2 ~`~ -2 01
f~,tc a~ •rtaFC:t~
3 t, t UC!!' Ct~'1Q! t Y. F t A.
RRG~R F`piTRAS
C;.lnl( CIa~UiT Cti;+~Tn
. , ••~ : • O" ~•
- . 513088
I FURTHER CERTIFY that I w~71 register at my local addsess when the registratiob books reopen. and eompl~ v~ith all
cther requirements of a legal resident of this State. ~
I FI7RTHER CERTIFY that I have no intention to return to m~ lormer domie~e. and I intend to remain in , ~
, , 5T * L U G 1 E , Count~,
~'~- J c - ~(:rt~
F'Iorida, permanenti;. _
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Sworn to and subsrn'bed before me tbit _l.p" daj of _~ ~1~ .~i~t-~.~~ ,
.w.D._ /98~ ~(~ ~ S C ~ I1~ ~- Del k. .-
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ROGER POI TRAS, CLERK OF C IRCUI T CO~tT , ~
ST. L UG I E COUNTY, f tOR 1 ~A •
- BY: . ~ • •- .
~ ~.~ .
~ EPUTY IERK ~
' ' ~oc°n~" 3~ PaGE i~
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