HomeMy WebLinkAbout2094Declaration of Domicite and Citizenship
.
TO THE CLERK OF THE CIRCUIT OOUBT.
ST. Ll1G 1 E ~pU~y, ~,p~A;
S1S4' ' ~
515422
T63s is ~ deelaratton ot Domjc~e and Citjuas6ip i~ tbe State at Florida tlut I am IDins this dq ia aooordanos. and ia
o~aformit~ witb Seetjon 222.17. Fbrtda Statule~. ' .
I~vas tormerl~ a kgal resident o[ ' , ~~ . aad I
~~q , IG4) 18tat~
resided at L v~ ~~• , ~- 8o~vever, I bave e~nged m~ domie~3le to
18tre~t aod Noob~ - •
aad am and bave been s bona fide nsident of tDe St,ste ciFlorid~ iinee ~~~ da,~ d
~~~~~ ~ 19 R~3 - and I raide at ~ S^7 ~.Ur ;~:iP
(S aedNumMr)
~ sS7'~ . ~.,~ _ ST. LtJG 1 E ~~. ~,~
~a4~
and tLis statement is b be takea as m~ declantion at eitiunsLip. adwl legal residenee and domieDe in tbe 8tate d Florida.
" I F fOR THE PURPOSE -OP ENROLL ING
CHIIOREN IN SCHOOI~ PLEASE STATE
THEIR NAMES:
i
-i~~ •
~„ ~ ~~ % ~~s~~ J
~ .
~ ~ .~'/. ~~~.~
.~.
I F'~JRT~R CERTIF'Y tbat I~vDl register at m~ loal addnss wben tbe registratioo boob reopea, and eomp~ wkti aD
otber ~qniremea~s d a kgal n~e~ ot tLis State.
I F~JRT~K CEHTg'Y tlut I bave no iatention to retnrn to m lormer domie~e. aad 1 intend to remain ia
- --~om : , . COtiIIL~~
F7otida. PeTmaaeOt~i •
``~ ~OUIy j,~
/ 7~
~ / ` ~'o~,
o~. :~
v: ,t ~:~ ` :~
~, '••= ~.; a :~aS~: oQ~o
/. ~` ~cu+~~r.F~
IF FOR HOMESTEAO~PURPOSES~~-
PLEASE CHECK: i
~ ~
1981 JAN 30 P!9 ~ 10
/
~ ~ ~~
.~i-~~~ ~` ~/
> ~
~~~~-7 ~ ~~ ~~~
F~~fo ~hr «cuNnFo
SLLUCtF CGUHTY.fI A.
RCG~R POITRA5
CLERK GRCUiT CtHlRi
r~i:^.r,R^ :'c :... . .. - -- - -
"~ ~ z~~~ _
Sworn to and snbsaibed befo~a me thb J U da~ d ~~ _~7~ .~~
. ' ~ .
_~.. /98/
ROGER P~,~RA~ CLERK OF G IRGU! T COt~tT
ST. UG I E COUNTY, fLOR 1 OJ1 •
~ ~ ~~
. ~
~ _ _ BY. ".-\l~*~_ ~
` `t~eruTY ~
~ :
_ ~~ ,~ Y ~
- - "r~~1s~.+~'-a? ,~ ~., r .:
~Glt7~ .
CAk~~e c ~:~soN .
..
B~(~~t~ PbGE~,V~S
. • •, ,~~
.
. .
~ j . ~~
`~'
~
1
,
~
~
. ;
,
;
I !'r. r -t r , ~
-' }'~~'~ ' . . .