HomeMy WebLinkAbout0651 C~~c~ar~~~~~n ~~ma~~~e an~ ~~~i~~~shi~ ~
. . .
.
. • ~o~?~~s
TO T~lE CL~RK Ol~' THE C1RCU[T COUItT.
ST. LUG i E CpuNTy~ FI,ORIDA: -
This !s my declantloe o[ Domicile and Cit~:.enship in the State ot Florida that I am C~ting this day in aeeordance. ~nd in .
eonlormity with Sectio~ 2`~,1T~ Florida Statutes. • ~
~ ~ • ' ~ •
I wa~ tormcrly a kgal rrsident of J` . ~GrL~~~ and I
(C~t?1 lSt~td
resldcd at . Howevor. I havic ehanged my domicilc to
(strNt a~nd Ku~a~)
~ad am and hs~e bcen a bona lide resident ot the Stute ai E'lorida si~ce ~ d~y oi
,19.,.,,~~i~nd 1 reside al ~ 7~ dZ ~Gl% Q~~t~ ~
, (Street and Namper)
, - - ST. LUG I E . ~ ~ptr. Florida,
T' l(ait~) . ~
aad this statcment tsto be taken u my declaration of eitizenship. actuat kgal resldence and domicile in the State of Florida.
IF FOR THE PURPOSE OP ENROLIING IP i'OR HOHESTEAQ PURPOSES~
CHILOREN IN SCHOOL~ PLEASE STATE ~ PLEASE CIfECK: ~
TNEtR NAMES:
fltEfl ~'IL• ~fCtiit0E0
aT.~uci~_~~u~+rr fu. ~
ftG~Er ~~~:RAS
CLfP.[ i '~JIt CQURT 91
RE~t!F~ Y;=.t=;£1,~.,.~1
. MAr 6 3 46 PN'75
30'~425
_ - •3 .
~ ~
~ 1 FURT}IER CF.RTIF~ that J vtiii register at tny loc.ai address when the re~,~istralion ba~1;s reopen, and compl~ with aU
~ other reqeirements u[ a lc~al residcnt ui this Stala ~ -
~ ~
~
i
~ _ I F IIE;t -,'ItTlF ' that I bave no inirntion to return to my f.~rmcr domicilc, and 1 intcnd to rcmain in
$T . L U C 1 E , Cca!nty.
E (City) .
~ }'lorida, pcrmancrmi,•. •
.
~ ~
~ •
.
\ .
~~t1~~~. ~ .
~ 'tJ' 1. ~~~~i~r•,,~ -'••_.~.Y,~~. .
1~ • ~ '
_ 'j` -:~'~''~~i.,;-{;;r:. .
, ' `~'.~a
~ ~~G~:~-v ` ~
_ ~ . `''t~ e~ ` i
_
, } ~
~ t •~yfMl~~~..~-1',~ ~
~ .-l i.+ .s''. ~;~z ~A''; ! ~ e " - - -r
~,~~:y:•;r~ v .y`~•. (t~.mc,.
~..:~4 , L 'R.
y~"~•. _ `1 r__. H C ~
* -
~ • ~ ~ • _ . ` -
v_/~'- S?a` U`• (t.ddrrns)
, ' ~~f ~J!l 1~11~t_ rr~ .
~ S~sar u t~~ ~~n+i`. i~>~erit,c•d L~•f!~t~ t~ic~ tii~s,~_. d~y of
~ A.U. 1:~ ~I_~' ~
~ - -
~ R(~i
tt_ft_ Pt)_ Ti:!? C.!_.i_E2{{_ (~f- C I i Ctt I'f _::OU:21'
~ Si-. L UC I C CnUt~1TY, F L.OlZ 1 U/1 V
~ ~
~ ~~~.1
~ ~ ~L w ~ .
ii~ / ~j 'UTY ~Ll.ltl:
~
~ U k ,
~ 600K~~~ PAGE
A(;~?i.:.~~,'ti
- ~
~~t~ ~ . _ ~ V .
~ ~~3 .
?~~r~ ~ _ ' ~t-