HomeMy WebLinkAbout0566 t~~c~~rG~~a~n ~r D~m~cile arad Ci~a~~nsh~p
~ ~ ~ .
~ ` - 3lasss
.
TO THE CL~;RK OF THE C18CUIT COUItT.
ST. LuC 1 E oourrrr. ~.oR1n~s
Tbis is a~y dcclaratton ot Doraklle and Citizetuhip tn tAe State ot florida th~?t I am qing tAis day tn accordanee. and in _
eoAlo~naity with Seetion 2~.17. Florida Si~tutes. ~
. <
1 was torm~rly a kgal residcnt oi • ~ atsd I .
L' t~"- (l~it lState)
nsidcd at ~ y-~ ' O~ 7~ - Howevcr. I b~ve elungcd my dotsucilo to
1&re:t snd NnmOK) • p -
u~d am nnd lu~~
c bcon a bona fidc resideat ot the St~io ot Florida slnce l" l~ dpr of
19~.~. ~nd I ns+de at ~~E' R h ct I2 c~ o~ 4 h~ •
S. . cStrest.nd Nuanber) -
_,L ~ ST. LUG 1 E County. Florida,.
cc~~)
u?d this stalcment is to be takcn as mr deelaration of citizenship. actual kga) r~sidenec and domicc~c in tho State of Florids.
IF FOR THE PURPOSE OF EMROLLING - IF iOR HQHESTEAD ~URPOSES!
CNiLOR~N IN SCHOOL~ P~EASE STAT~ PLEASE CHECKS ~
THE IR N/1HES:
. 3~~=~s
• ~ ~ R~Ay~ R~ ~ r
i~ c ~u~i~ra
CIERKCF~ a :
' - REQI:RL? V f~ FIEO ~OUR1
- ~1[ ~ f s
~~T~ ~
. ,
- ~
-s
I l~'UR77IER CERTIFY that l~vill regi~ter at my )ocal address whcn thc rc~istration books rcwPen. and comply witi~ al)
othcr re.quirements o[ a~cgal resident oi t!,is Siate. _
I FUJ~Tl~~:t Cli~~~ that I hnve no intcntion to rctun~ lo my tormer domicile. And I intend to rcmxin ia ~
~~v t',~, l~ fi~r~ ~ . $T . L U C 1 E . Couniy. ~
(Gty) .
Fbrida. petmanen~i; . -
. ` `
k
~
~
. y
~ ' .
. . . a (.a ` •
~ • ` ~
_ ~ - ~
. ' ~
~ ~ ~ ' • " • ~ ~
/
. ~NafltO)
~
. ~ _ ~ __,__~a~F~, ,rs
~ y, T (Ad reu)
Sworn lo tiubccrii~ed bc~toro mo lhis d~y of ~
, + ' . A.1~. l~J_ / ~S ( .
RnGfR POI RhS. CL~RK OF C IF:CUI T COlJt2T
~ ST. LI ' GOUNTY, F I.OR i,U11
E3Y: a-c~c~C_ ~ .
CPUTY LC1tK
~
~ BOOK PACE 5~ ~
. ~r.~~ F~,~.~~ ~
~.T- ~ w
~~,a~'~.~~ ; - . - _
s ' ~ ~
~ -
w - - - ~ ~ -