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HomeMy WebLinkAbout0396 Z D~~:l~r~~E:~~ of Q~rnie~~~ and Ci~E~E~~~E~p ~ i ~~~u ~rin: srn~r~: n~n c~~un~r~~ ~r,~x ns~~~ssoit. 300'766 ; _s•r. LucT~_..___---coun~rv, i~~c~itinA: ~ _ , 'll~is i~ my cl~claration of Uc,micil~ and Citizcnship in thc Statc of I~lorida Ih:~t I am lilinb ihis ~l:ry in ~ ~ .icconlancc, an~l in conformity with Section ~'2.17, rlorida Statutrs. ~ ~ G~~ 1 was fanncrly a k~al resi~l~:nt of -_l;C..F1~' _ - and 1 ~ ~l (citr) (s~ale) ii C~ r~sided at -.-~J . Ifowever, l have changed my domirilc to ~ (Strccl and Ntumlxr) and am and ha~~c becn a bona ti~lc residcnt of thc State of I~lorida sincc- __-_.1 day o1~ ~ - ~ . , 19~ anci 1 resi~ic at ~ C~ 2-- ~o-~~ ~ (SUrM and NumMr) J • . S~ . Luci_e--- County, rlorida, (~'~v~) ; ,~nd this statem~ nt is tc~ hr takrn as my declaration of citiunshi~~, aciual Icgal residcnce and domicilc in the State ul~ I~lurida. ~ ; z Qnsrr. lirre auy pertinrnt fact>, such a~ wle uf pruprrty or bu~inr>s, or rrlinquishment of employment at to~mer ~ domicJr, remu~•rl uf (amily tn ncw d~~micitr. purcl~:ur of humr, clcJ E?'1TERI~:G CIiTL`URE?: I"~ SCHOOL: ~ HOMLS'fEAI) E~EMPTTU`-;: ~ ~ If enter~t~g children in school, ~ please 1 ist thcl.r narnes : , ~ - r ~ _ _ ~ 4 ' ~Ij Y ' ~ t ' FILEO ANO RECORDE~ ST. RO ER POITRAS ~ CLEaR C1~CUlt COURT ~ RECORD VER~f1ED^...~+.`~~ ! FEd ~I 3 PH'~5 ~ - ~ t . ~ ~ 3~~6 : ~ ' ~ ~ 1 C'UKTHER CE:RTI}~Y tir!t I will rr~~istcr at my loral address H~hrn thc rr~istration books rcopen, and ~ r~mply with all othcr rc~~.~ir~m~nts c~t~a li~al msidcnt of this Statc. ~ ~ 1 fUR'I~IiF:K Cl:hTffY th:~t 1 h:i~•~ no intcntion to rcturn to m~~ fonncr domicilc, and 1 intcnd to rcm:illl 111 ~ - -----=7`P~=~ --U -er-~_~~e, f-• - ST. LUCI~ Co~~ut~-, R 1~lorida. rt•nnanrntl~~. - cc•~~,~ ~ ~ ' l l • - --~-~-~C~~ ~e` - ~ :..a..:..~..,; ~ G~v~~ ~ , i . . ~ x•. ' \J~~~I~~~ ~~1 ~ - ~ ...~1 R~;.,,, .j ' 5 ~ - ~=',.O : S IGi1A'i'URE h ~ • ' YS)~~ ' y ~,~°~'.~to ancl,sc~tis~t'.,rFbcd bcli~rc m~ ti~i. day of ~ • . { + ~ ~ - ~ . .~.I). 19 ~'J *z----:..._------- - - - - ~ `r, . .r ; ~ ~i in~; c c.res~ ~ -:~.Ef~G'~~'•p~~r,~~:~~ C11'sR1! CIRC~ . . COL'RT ~ ~ _ , i~ lorxda ~ ~ ~ gy „ , DcF- C~ e r?; ~ ` ~ ~ (Tt~ be r~ccul in :Iuplicrlr : :~,.~1 fJrJ v:i~h ('Irrk /'~•ruit ('~~:~rl. anJ duplir.~l.• ~ci~l~ laa Assccs~rr) ~ 800K 2JV PAGE ~ ~R ; _ _ ~ ~ - . . 4 _ _ .~:~'.Y