HomeMy WebLinkAbout2710Deciarafion of Domicile and Citizensi~~~
TO THE CI.ERR OF THE CIRGUIT OOURT.
ST. LUG 1 E apv~y, ~,p~~;
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T6is is m,~ deelaration at Domidle and Cjtiunsbip in tbe State ot Florida that I am filing this da~ ia aooordanoe. and ia
ooafwtait~ witb Seetion ?22.17. Florida Statutea. '
~ I~vas tormer~ a kgal resident al ~O /1/ i9 ~-~- ~9 ~~/4 ~Y- Y aad I
. l(~t~I ~ ~ IStwl
resided at ~/ G~/! ~1/~ ~A ~*. ~ AoWever. I 6sve ebaaged aq domics~e to
(8t~e.t aad N~b~
and ain and Iuve beea a bona Sde resident oi tbe State oi Florida ainoe . ~ i~ ~ da~ d
(,lX~ ~~~Y t1~G - l~~~and I rc~de at Z/ C~ ~_~ ~ C c7 ~ ~~
` (Str~st aad Namb.r)
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and tliis statement Is to be takea as m~ dee]antion of atixensbip, actual kgal residenee and domia~e in t~ State ot FJorida.
" IF FOR tHE PURPOSE-Of ENROLLING IF iOR HONEST~AD ~URPOS~Si ~
CHI~GREN IN SCHOOL~ P~EASE STATE PLEASE CHECKS ~`~~
THEIR NAMES: .
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~ 1981 FEE; -3 ~. _
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I FURTEE~i CER1`II~'Y t6at I~ ragister at my local addres~ whea tbe ngistration boob reopen. and mmp},~ w~tb aII
otber nqninemeMs d i kgal resident at tbis StaLe. -
I FUBTA.~k CERZ'~'Y tlu! I bave no inteation to retma to ~T lormer domia'le. ar-d i iat~nd to rea~ain i~
_.. . ~ b7 . L UC 1 E ~ Camty.
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Florids. Permanem3,•.
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Swora to aad snbxnbed beio~e me thfa ~ daj a[ /,%'o vL T~ t'~ ~ tJ C~' F3
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~ POITRAS* GLERK OF' CIRGUiT COC~tT ,
ST. 1 E COUNTY, ft 1 OA
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! . . BY: ~~,'
~lEPUTY I.LERK
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