HomeMy WebLinkAbout2130,
Declarafion of Domicile and Citizensf~.ip y~
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515443
TO THE CLERK OF THE CIItCUIT OOURT.
ST. LUG 1 E apUtv~ry. ~,p~A;
Thts 4 m, deeluation o~ Domjdle and Cttisanship in tbe State of Florida tbat I am bHns tbis dq in aooordanas. aAd b
eonto~mttj ~vitb Seetioo 2?2.17. Flarida Statutes. ~ ~
^ I was formerh~ a kgal naident o[ t,~iC1~ ~" . ~'°d I
~~ ~ ~~~--- t8tata
nsided st l~ ~Zc=~CP ~/'r.~~Sd1tLL~~However. I have cbanged m~1-domicls t~o
18teest aod I~Im~
d am and bsve been s bona Sde resident of tbe State o~ Florids sinoe ~ ~~°2 ~/ ~J d
1~~... and I naide at _'~~ ~ j 1~/ ~ .
f 47 !, -,e-~~, ~~~ _ ST. LUG I E~•~ a N~ countl. Fjo:ids.
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and this atatement is to be taken as m,~ deelaration a[ citizenship, adual legal rasidenoe aad domic~e ia tbe State d Florida.
" I i POR THE PURPOSE -OF ENROLt. ING
CNILOREN IN SCHOOL~ PIEASE STATE
THEIR NAME~ n ~
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Ii FOR HOMESTEAD-PURPOSES~~-
PLEASE CHECK: j
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1981 !,~~~ 30 ~~, ~ ~ 0
~ ~~~c~ t~c F~cown~o
S1.LUCIf 6 N1Y.F A•
RCGER ~~TR~~
CLEe~~ CIRCVIS CO ~
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~~
515443
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I FUItTHER CERTIF'Y t~t I wri~ ngister at ~ local address wben t}ie registration boolts reopen. and oompl~ wKh aII
otber reqninemenb d a kgal naide~ d this State.
{ I FIII~T~iER CER1'g'Y that I have no inte^ atiao~ return to ic~mer domie~e. and I intend to remda ia '
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F7o~ida. Permanent],,•. . (
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Sworn to and snb~mbed before me t~ ~ da d ~~ ~ YC -~ ~/ ~-~
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ROCER PQ1~RA$~ CLERK OF CIRGUIT COC~2T , j~
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ST. LUG 1 E- COUNTY, FLOR 1 WI • ~• ~
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