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HomeMy WebLinkAbout0492 ~i , . ~•i-_ ~ + ` ~ . ~.r~ t•~'i _y ~w~-,. . r R " _ ._i' . _ .y ~ ~r.,f: _a E..i~.> . ~ " ~ ~ • t i ! .i. ~ t..i ~ -.~s'it r.~ Y ~ _ i i ~ i ~ ,:~i> c'(~~;\ i 1 ~1 `,X ~1ti~t ~tit )E:. ~ ~ .1 ~ic i c~ ~~'70'7 v - t'Ot!~ 1~1'. I~l c)hil~~~: 'Ihi, i~ mv ~1~•cl;~r;iti~?n c~f i)c?niiril~• a~ui ('iti!t•n.hi~, in ih~: Stat.• ul~ 1~1~?r~~l ~ th,+t I ain tili~~t~ itti. ct,~~' in accur~tari~.~, an~l it~ rc~nf~c~nuily witit S~•'iti~~n „'.l"1, I~luri~l~i St;~tut~•s. 1 ~~~a~ futntrrly a Ir;~:~l residr~tit uf _~~G~~~/_~ - - - - , - Ll~l ~ - .ui~l 1 : (c~i~) ~tir.~i.•? ' ~ .~~?Cf~~?_rA_~~_ . I lov.~~vcr; t li:i~~t~ ch:+n,~ed m~' domi~il: t~~ ~ residc~l at - lStrrrt anJ Ku~abrr) ~ and ~+m and havc Urrn a bon:+ fi~lc n~icf~nt c~i~ thc Stat~~ of l=loricla sinc~ - day of ~ _ _ _ _ - - _ _ _ - - 110W _ _ _ - ~ ~ - - , ~ ~ .:nd ~ ~r~ s~d~ .Ec o --~~E.s~"S ~•s_'--~ ~~'r - i (Strret aud f3umtxr) F - SL-. Lucie _L~Z' __~l/C_/L.------ - . ~~oiinty, Florid:~, t ~c~~>•> ~ ,u~d this statement is to be takcn a~ my dcrlarc~tion uf citizenshi~~, actual l~gal resi~tence ancl do~nicile in thc State ~ ot' l~loricla. ~ - ~ (In~rri here ~ny pertinent f•rcts, such a> uf pn.perq~ or bu.~crsc, ur relinyuishment uf rmpluymrnt at furm.r ~ d<~micile, rcmn~al of famil>• to n.w dumicitr, p:~~ch:~u of h~~rir, rtt.) ~ ~ ~ Entering children in school: . jCi9 ~yan/,D /C • ~~~,/~ir/s ~ ~ - ~ %~rs ~ ~ a ~y] , y~ ~ ` # 'i liBC~it P3{i~#S ~ ~R1~ C::::lTt? C~tltT 1~ - - - _ _ _ _--~tfC~il~=-+FtEB - - ~ Irc~i i~ iz~!!'73 ~ ~ ~ i • F ' f g 2sz~o~ ~ ~ ~ ~ f ~ - ~ 1 FURTIIER CERTIFY that t will rc~,istcr at m~~ local ad~imss when thc rcgistration hookti rcopcn; ~.nd ~ comply ~vith all otlier ~equirements of a le,~c~l resident of t)iis State. ' . 3 1 FUR1'HER Ci:RTIFY that 1 li.ivc no intcntion to rrturn ta my fornter domicilc, and 1 intcnd tu rcmain in ~ l/~'/~ Count~~, ~ ~ ~.~T ~t. Lucie ' E ~ }=lorida, pcnnanently. tc~~,~i - g _ Y.`'_ ~ : ~ r- - ~'i a_~- Y' - " - - ' ~ :~,Q`~~~ •1~~~~:~~ ~ ~ ' . ~ ` ~ : • ' ~ { ,~\r~G~ ~ ~.'S~'u~ ; ~y ~ - _ - - ~ - - - { ~ • ~t , ~t - - - -~-~-1 - ~ :;i12 ~ (Addre..) ~ i.'f ~ : { ~''.~~'.~i ~ - r ~ i ~ . F' 's~ ~z ~ ' C ' : , ~ Sl~~Ici ~.R~s~a~cr1 bt t~orr ~rr ll~is ~ ~ ~ia~; ~f ~ " - : ~ . ~ ' " ~ ' ~ ° ~ r~~~~ : ~ • w'• v•~ :1.~). 7~ ~ r~ =-~w~-~~;a•-~- ^ ' . ~ ! ~ ~'~:~~~~.il~•'}~OITR.,S, Li:R~: CIRCUII' CCtiitT ~ ~ - - - - - - - ~ ~ , bppK~~B PACE 49~ ; ~ ~ ~n~ - ~ ~ .~t~:.5~ ~:1 . . ~r - (Tu 1rt' ~~~.~dr~1 ~n 5~:~~h. e!: .~nd i~e.~l iilrtt ' i~'ir~l. ~ r. ~~d 1~~~~.tl. .•;r.i uu~•li~. ~+.a v.~tl~ la.~ r~~. ..,~r) , ~ - - - - _ . _ . _ ~ ; ~ ; ~g : . ~y .~'gry~^~~~_r~.~,.~£a`-~,'v r..v,~V'~'._..~: a._ :T .~.c-i;>K"~`~"h~ .~5~.~2