HomeMy WebLinkAbout2348,
Declaration of Domicile and Citizenship ~
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S1S583
TO THE CLERR OF THE CIIiCU1T OOURT.
ST. Lt1C 1 E op~ry. ~,p~~;
T6is b m,~ deeL,ration d DomieDe and Ckiseasbip ia the State ot Florida tLa! I am fling thts dy ia aoeondano~. and io
oonfornaf~j witb Seetlon 2?'1.17. Fbrida Statut~t. '
I~vas lormer~ a 1ega1 restdent at \C_ i\'(\~ ~\{~ l}.~l ~~ ~P l A 1!~~ ~f'- ~ and I
IG'~,~) IS~aW
resided at ~ ~ ~v ~ . However. I 6ave ehia~ed aq domie~le to
18trMt aed Nmb~N ~
and am and have beea a bona Sde resident of tbe State o[ Florida sinoe •'~ ~~ d
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and tbis s4teme~ is t~o be taken as n~ deeLntion d dtizensbip. aetud kgal reaidence and domiAe in tbe State aI ~'brida.
" Ii FOR THE PURPOSE~Oi ENROLIING
CHIIDREM IN SCHOOL~ PIEASE STATE
THEIR NAMESt
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If FOR HOMESTEAD"PURPOSESi -
PLEASE CHECKt ~ :
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19~ fE6 -2 PN 2~ 27
FIIEC tNC ~~ CORDER
S1.LU~If CGUNTY.fLA. .
ROGER POITRAS
CLERK CIRCUIT Cf~ ~
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515583.
I FUBT~iER CERTIFR t6at I w-~1 regist~r at m~ loeal addnss wben the registratjca boo~i reopea. aad oompl~ w~hb aa
other reqnireme~ d a kgal reade~ ot this 8tate. .
I FIJRTAER GERTII~R t1~t I have ao iateatim to retm~n to m foraier domie~e. and I iatend to remaia ie
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Ftorida. permanem7~,•.
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RQ,~C~R P~Q1'~RA$,, CLERK OF G IRGUI T COC~tT , -
~ ST. LUG 1 E GOUNTY, FLOR 1 OA - • -
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ErutY K
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