Loading...
HomeMy WebLinkAbout0171 ~ . e • r • • ,i ~ .r--. r'4 i-'~. t I~'~ o`~ e D,.•~ 4f:': ~..~.:'~.~1 t~.'~ ~•.~i~`~:~~..:: c..:; l;. '~i~«ti:•: t.~s~_~~ IO'flli S'1~\'I~1: ~~i~l)CUtI\11"!:1\ r~titil.titiUlt, ST. L.UCTI, ~302 - _ _ ('O~lNl~,l'. 1~ l.nlt I U,'1: 'll~i~ i~ n~y ~l~•~laratic~n ul~ tac~iui~il.• an~l ('itiic~~:hi~~ iit thr St;it~: ot~ I~luri~l;~ th:it 1 am tilin~ this ~i;iy iit a~cc~r~lan:r, .~n~t ii~ c~~nformity ~vith ticrtic,n '_'~.17, I~lori~la Statut~•s. ~ /0/tZ~O~.e~.~~-? ~~c~s-U.-? 1 ~va~ li~nn~rly a Ir;~al rr,i~lrnt ~f ~ -a~y-- - - - - • _ :~nd l (c•~tY) (S;atc) ' ~~lt~v .-~~-l~-tt--~ _ _ _ - . . llo~vrvrr, 1 ha~~c ch~in~r:i ~ny dattiicil~• tu i.•sicl«I .:t - . (SUcct :uid humbci) an~l am and havr h~•:n a boi~a fidc rr,i~lcnt of thr S1:~tc ul' I~tc~rida sin~~ d:+)• uf ~ - - - _ . 1 _ , .ui~l I r~ si~tr at ~ --lO /..~~~c%"-- -~ti-- - - - - ~~GL~C~ (SUcat ~ud Nuinlmr) ` • `~~'L(~' ~~-u-~ _ ~ . _ - ~ - _ St . Luc iL- - - - - C:ounty. Florida, - - - (city) ;:~:el tlti, titat~tncnt is tu I~~ takei~ as m>' elrcl.traliun of ritiirnsl~i~~. actual Ir~.i! residrncc ard domicil~ i~i tlte Slate ~,1' illcirid.~. (lmrr. hc~r :u~y prrtinrut (a:1~, ~~~cL ac ~e!.• ~~f pn~prr bu..iurs~, ur rrli:~yui~hmrid uf cmplu}mcnt al funner Jutnicile, tcu~ut:d uf (a~u~l~ tu u.•~+ d~~~nicik•. p~.n liasr uf h~~tnc, rtc-) 1:.'.~i.::J,~~; Cj~Ti.i,-:1T:,.~ 1~? Sl.l~~~~)L: L~~)i"i1,S•i1:1:iI l~rlir'~i'II~'1'J~I`.. If c~~?~~~ri.nb c?~zlar~~~ in scltuol, ~ ' ~~le~s~ 1 isL ~}~ei.r r.~~~~es : /~uu,1~~--~~ ti ' ~ ~ ~ ~~-~.u. l~ ~~'~~-vL~ ~ - C~c -¢-•c ! -C~-.~ fILEO AND RECOROED ST. ~UCIF COUNTY f~A, ' ROCi; PpITRAS i r~~~o RK C;RCUlT COURT ~ . Vc~ iF!~p ~ ~ 1 ~ ~ 09 ~M ~ ~ ` TS Q ~ . ~ 2,qg302 I 1=U{:"I H1:lZ Cl:1ZTli•l' tlr~t I~s~ill m~~i~t~ r.~: m~- Ioca1 :~Jdr~s~ ~;-hcn ihe rc~istratic~n l~ooks r:c~~~c~i. and ~ ccim~~ly «~iti~ all othcr req!~irrm~~ilts ~~f s lc;~:t) r~••ic'~•i~! o~ this Slatc. 1 FUS:'fHI~.R ('i:It~fiFl' ti~:+t 1 h:~~~c iio intcntic~:i to rrturn to m>~ formrr domicilc, an:! 1 iz}t~•ncl to r~maii~ in ~ sr. J_uclL ~G~~ J -~.1~t-~.e~ co:,i,t,•, - - - - _ - - - - - - - - - - 1=1c~riJ:i. P:~n~iancntly. u•~~•~ - ~ ~ ~:.1~zi~,'? /~~~~d-`y~ - ~y --~TC?:~1Tt~RE ~ ~ /r~ , - ~ - - - - - - - - - - - S IGi~f;'i'i iiZ: ~ . _ ' ' , > ~~~~orn ic~ :~n:? , ::ihc•c! bc•f~~r.• nte fhi. d:iy oi a~ ~~~.~~li~~Ni(~. . ti-.. ~ - - - - - - ~~~1~~p i+~'(+~. - . `c`~' ~0~~ ~f,E'~-~, _ , ~ vie~••. ta~ . t•.::~ ~'circ ~ ~ );nC;F.". ~ ;t;~< ~ ~~r ~ l~ ~tie~c~c~ ~ ' ~ { - :~~9 ~ - ` - '~~`a3 e ~ : r ~ ' ~ - ...,dl..J . t =Y", . v' t~. . • : - '~er~: ~ . ..c t" ~ . ~ . s? : • x 'i~~ ~ ~ {T~~ hc r~er rJan J~~~r~t• n:11 fi1rJ uifli l'1~•r~ ('erruit 1 uur~.:mJ dnpli. ~~r ~vUh Ta~ A.,rs~~~r) ~ ......,<<,,,..~~ o R 171 :z~~ ~ BOOK PAbt ~ ' - ~ ~ ~"~-~~7 ,:a- _ , . - ~ _~w_~~-r~