HomeMy WebLinkAbout2847 . [~~c~~r~~o~ of ~~miGilc~ ar~c~ Ci~ix~nship ~
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TO TNE CL~;1tK Ob` THE C1RCU[T COUItT.
ST. LIJG.I E COUNTY. FLORIDA: . .
Tbi~ ia my dcclaraltoo ot Aomicile ~nd Citlzcnahip in tbe Stato o[ I~'forida that 1 am Glina tbt~ da~r in aeeordsnco, and in ,
contonaity wilh Sccttoa 22'1.17. Florida Statulea. ' ~
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1 was t~rl a kgd residcnt oi ~l~ /~'~a,.-,..os we.~~~-.c,~~/ - -c-^-~ ` and I
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restdcd at However.l have ehanged my domicilo to ~
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•nd am ~u?d ?u~vo bcca a bona rde res~dcnt of the State of Florida sinee ~z,~ ~ ~ day oi
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19~,.,. and I reslde d ~ 4~ ' •
~ (St+~t aad Nwaberl
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aad thts statement is to be takea ~s my declantion oi eitizenship. actual kgal raidenec and domic~e in the St+~te of Floride.
IF POR TNE PURPOSE Of ENROILING~ If F'OR HOHESTEA~ PURPOSES~
CHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~
THEIR NAMES:
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~~c~~ .~G~!''~' 7'u 1 ~-+-~s~,a-L~<•! • . f+LEO R40 RECORpEO
:T.LUCIE C01tNTYfLA.
F.CGEfi. ~O~iR15 ~ ~
~ t~ CLERK C'ZCUIT COURT ~
. PF*ORT~ S'~ :!ilE'~
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. ~ . - . J~ 11 I u9 PM ' 15 ~
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I FURT}IER GF:RTIFY tha~ I will rcgi~ter at my local addres~ when the registration baol:s reopcn. and eon:ply .vith ali
other rcquirements o[ a legal residenl o! this Statc. -
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E 1 FURT}iE;t CERTIFY ihat I ve no intention to return to my former domicilc. and I inlend to remain in
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~ Florida. pr.rmanent i~ .
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~ Swo'rit4~NrNJ~s11b`ccrilx~d l~etote tne this day of ~~C
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~ Rn~~R _P01 T%1 CLFRK OF G{F:CUI T COU2T
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~ ~T. L UC I C COUNTY, F L.OR i.UA .
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aoaK24~ PAGE~849
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