HomeMy WebLinkAbout1916f -
Declarafion of Domicile and Citizenship ~~
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515;~5
TO TNE CLERK OF THE CIRCUIT OOURT.
ST. LUG 1 E op~. ~,p~~;
Z7~L d aq~ deeluation ot Domicilt and t~tir.eas6lp ia tb~ Stat~ ot Florida that I ua ~ins this dq in ~ooordanot. aad h
oonfo~mit~ wfth Sectioa 2?'1.17. Fforida Statut~s. '
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t was former~ a legal sesiden! d ~ ' ~~ ~N .!~ ~ A7ll /-~ ~ I ~
,~~ a ~~~ ~1~ /c~,~ /V a ~c~s~ ~sw.~ ;
~ 8owever. I have eban~sd ~ domic~ to
~ (BtrNt ~ed N~sb~ . .
and am and bave beea a bona Sde resident ottbe SW,e a[Fbrida ainoe /S T, ~ d
- ~ G-"~- 19~~,, aad I re~de st ~ ~~4 '~ ~/~od/L K ~ .f e /'T.! ~i~'~y '
~~v.f E~1 ~Ei9C1a ST. LUG i E~~N~ /
caaY - C«~4. ~0°rfda.
and tLts siat~emeat is to be taken as mu deelaration d c3tiunship. adua] kgal reaidenee and domie~e in tbe SLaLe d Floa~ida.
' IF FOR TME PURPOSE -OF ENROCLING
CHILDREN IN SCHOOL~ PLEASE STATE
THEIR NAME8:
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IP iOR HONESTEAD-PURPOSES~--
P~EASE CHECK2 `~- ~ .
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515295
19B1 JAtI 30 _AFI- il= I 4
FILEO R~C F~CO-+f f:-
sr.wciE c~uHrtr. i ~ n.
ROGER P01 ~AA5
CLERK CIReUtT C^L'11. rf~1
ilCCCFO ~'f P,: •c +~ ~..!~! ' . ._
I FIJBTfIEEt ~'Y t6at I wID register at aq lonl address whea tbe re8isfr+lan boolcs reoPen. ind eomp~ writb an
other reqnir+emenb d a legal reaideM ai tbis SW~.
I F[JRZ~t CE~tTg'Y tbat I have ao lnteetion to r~torn to m iormer domie~e. and I lntend to nmds ia
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_ ' . ~c~cil .
~7o~ida. permanent~,•.
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Swor~s to and sobsaiibed belora me tbb 30 ~
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~tOGER POI TRA$~ C~~RK QF C IRCU1 T CO~tT
ST. LUG I E COUNTY, FLOR 1 OJI •
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BY ~ ,~~„~
, , . , ~E~UtY t.LERK
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g~ 34`~ PaCE ~910
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