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HomeMy WebLinkAbout1723 ~~c~~~~~~s~~ c:~ ~~~r~i~~~~ ~j~.i~:~~,~.~~~~i~ ` . ; t ~r.~ ~r~~r s-rn~ri: ;~~u c~o~?h~c~~ n~ nssi ssu~t. ~994~8 ~ ST. 1.UCI1;-- - ('(~UN~I'1', !~t UiZIUA: 'fliis is niy dcrlaration c~f Uomicilr and ('~tir.~•nshi{~ in Il~c St:ilc c~f Ilori~la that 1,int tilin~; lhis day in a~c~r~l:inc~, :u~d in cunfonnity ~vith S~rtiun ~'~,17, I~Ic~rida Stalulr.. ~f/ ~ 1~~•as formctly a lr~al rcti~irnt c,l' ~ON C. /y and 1 - - - . - N - - cc•~~> ? cs~a~.~~ rr,i~lrcl :~t -/~o[~/Yo~c'l~! -~D,------ .}io~vrv~r, t ha~~c changc~i my clomicil~ to (Strcrl aud Numlx•r) a,i~i ,~m and ha~~c: b~:cn a bona fi~le r~si~lrnt of lhc St: tc of l~iorida sinct __L~ day ol' _ _ ~"1_~~r~ - - - , ~ 9_ ~_t~ , a.,a , sid~ a c ~ ~ 3_ ~=4--__ _~t_ /~~y_~ t_f_o_ - __R_~- - (Slrrrt anJ Numbcr) --~Q_/Q-~ ---1_ _/_~%P~/= SL . Luc~e Count~~, rlorida, (c'it)) ~ ::iicl ihis ~t:it~~m~nt i; to l~c t:ikc?~ as m~~ dcrlar:~tion c~f ~itucntil~i~~, :~ctual lr~.il r~.sidciicc and domicilc i~i thc Staie ~ ~~t rlorida. ~ , ~ (lnsrr~ hr~c any pritinrnl fa~~tc. suah ac salr uf pruprr!y or husiuris. or reliu:~ui~lun~nl uf rmplo~•mcnt at furmat ~ dowi~ilr, ~cmo~al of (amily tu nc~~ d~,~uicilr, nur.ha~r of homc. rlc.) E'~:'?L•'Y.T'~'G C}IILDRE?: 7t1 5CHOOL; ~ HOI~~STE~1D ~`ETiPTIO`:: If er.i~eri:~€, children in school, please 1 ist ~iteir ~za~es : 1 sT~D~c+E cauwn ~i~i. RosE ~ po~ra~?s CLERK :,:~~UiT COUR ~ RECOR~ vEF:~IED-~-.~~.~~ ~ ,f~ 11 I i ls Ak~'75 ; i 2994`78 ` i ~ ~ - ~ ~ ~ s 1 FUlZ~I~HI~K C'l:it~Tli=l' that 1~~•ill rc~~:sicr at my local a~ictrrs, ~~nc~n thc mp~_istration hool:s rco~~e::, :~nd ~ r~~ ilt v with all uth~r ~r~~!iirrm.•nts c~i~ a lr~;al rrsi~tnt of this Siatc. ~ ~ - ' 1 Fl?IZ"flil:R CI•.KTI1=1' that 1 it:~~•c i~o intrntic~n to rcturn to m~~ f~rm~r domicilr, and 1 intcncl to rrmain in ~ : ~ _ ~ oR ; ST . I~UCIL•' ( oun y ~ ~ - ' t - - - - - , , ~ ~ [~ior;a:,, rcrim~n~ntty-. u-~~,> - i c , ' ' ~ -1~~%~~~!-~_°~ ' - ?~~~-LU :-z-. . - - J7~ilj~~~- - Q~ .c. ~ •.3 :•::~~1~ Id. ~ ~"v i. F r - r;,'3 f ~ r a: - i' r " , t.,,~~;: i~~ SIG:vN7'LDRj.: ~ • ~ ; : : . : § ~ - ~ S~ ? _ »cl ~ub~~ti~~'~s' .~i'~~rc• mr thi. _ ~ 7_ da)° of ~ :.,a. ~ - ~ ~ `~i- _ ` n. u. t t, ~ 7/3 ,L"~ ~~~iC~ a~ • z. - " : - _ _ - - • - - - . i`:~37 ]il~ . rC'SS a GI'.•R. ?~4~.~,k ~ j3:1~ CC~t'jt"~ ~ ~ ~ v.~c.E~-¢- , , ~ ~ _ T'•oric'.a ~ ~ AY C~(~, (~:2+- V C' F' rt' ~ ( (Tu Ix• • • .J nr~ ~in d I~Ir~I ~~ii~~ ~ . . : ('~r~ u~l ('uurt. ~nd ~lu~deratr ~viih 7a~ Asx~a~or) 4 - gooK235 ~~17~ ~ ~ . ~ t _ _ -