HomeMy WebLinkAbout1644
,
Dec{ara~ion of Dor~icile and Ci~ix~nsl~ip
.
51~30'7
TO THE CLERK OF THE CIRCUTT COURT.
ST. LUG 1 E Cp~Ty, l~-I,pRIDA;
/
~f
This is my declaration oi Domic7e and Citizenship in tbe State oi Florida that I am fling thLs da~ in aceordaaca. and io
conformit~ witb Section 222.17. Florida Statutes. ~
I a as formerl~ a 1ega1 resident of ~~~'~^~/~ , T~~ and I
dl(~7) (Stat~)
resided at l~~ y0 s~ ,~~ %~/~b ~% r~ /~l~e Hoa ever. I have changed my domi~e to
(Strseland NamDer) ~
and am and have been a bona Sde resideat oi the State oi Florida sina -7 V day oi
~~~~~~ _ 19 7` , and I reside at ~ y~ /+~ .~l~/'t/f'
(St.eet and Number) _
~~..i t,o.,~ /f.Ps. c•~ , ST. LUG 1 E Countr. F7orida,
I(~1
and this statement is to be taken as my declaration of eitizenship. actuallegal residence and domicile in the State of Florida.
' IF FOR THE PURPOSE Oi' ENROILING
CHILDREN IN SCHOOL~ PIEASE STATE
THEIR NAMES2
~
- ~~
IF FOR HONESTEAD-PURPOSES~ ~
PLEASE CHECKt ~
1981 JA~I 13 A!i i~ 48
Fsi,EC tti( F: CObili 0
SLLUCIE fGUYTY.F1.1.
ROGER POITR ;S
CLERK CInCU:i C(~URT
:S:fR: ~ir'-i~ - -~J~-
51.330'7
I FURTI~R CERTII~'Y thut I w~71 register at m~ local address ~v1-en the registration books reopen. and oompl~ with aD
other reqnirements oi a legal resident of this State.
I F[IRTHER CERT'ffY that I have no inteation to return to m~ lormer domic7e, and I intend to remain in
; 5 T, L U C 1 E ~~tj~
t(St~) .
F'lorida. permanenti~.
a•'. .a'-I` r~<t;~f~,' _ . .
~~•`
`~~ , ' ~1 .~:j . i~~' 3 ~~ %/j/j - /
., ~' •.~=.. .,.~ ~- /~ "I !r=" %%
~' i ~i .' .A•. . ' f . ~ ~/` .. : V '
~; ~'• i
` +~,,• . ~%~.. i~-J C~,• . ~rir ~
~~~, ~ ~ ._ ~ •, .. ' w : ~ ~ .
. ;~: ~•'-:t'-_~` . ~.
: ,~ s` ~ ~~
,R~: • ~ r ' i '
. ~ ~, ~~ ~
• .3C „ . :
. ~~.,..: ,~. • ~
.a.~ ~;
. ~.~1:- ~ r .-~ .
. ~t~,«~.~, ~.•~
SworD t0 ~~Iq~~befOTe me tblf /` ~l~ p~
~ _ ~D._ / 98/
ROGER ~1 TRAS* ERK OF G IRCUI T COC~2T
' ST. LUG ! E COUNTY, f LOR 1 ~A •
!-
.~
~ - BY: '~ ~ l
; ~~, _ , EPUTY I.LERK
f .
I .
~_
~?a~ ~ '3- va" Mee1~1'EN~
' (Nam~)
(Addreas)
BO(~l](~`~6 P~~~~
,.
• .~„
. .~
.
• -
. ~ ,~ ~
.+
~
~
3
:
~