HomeMy WebLinkAbout0664 vG~+~ta~ a~~v~ ~ v~ vv~~~~v~~v a. v.a.~.~..~¦ ¦.M
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To~ c~x oF~ ca~cvrroou~r. 31S'~80 ~
, ST. lUG 1 E QpUNTY. Fi,pRlpAs
TWs is m~r declarstioa ot Domidls ~ad Cit~ensbip ia ths State ot I~'forWs tb~t I am fllioa tbis dqr in aeoordanes. and in
~oofoe~mity ~rith Seetfoa 27l.17. Florit4 Statute~.
I w» t~ a k~al tosident ot ;~i ~sd I .
f
residcd at ~il ,s ~~11~.~ ~ Tr~, 'L_ c~/` .l 01~!~Ho~rever. I t~ave chae~ed avr doa~Ieils to
~ IBtrNt N~b~r1 .
aad un and bsve been a bona fide resident oiths State ot Fbrida sinos .~~.y
~ C.~_ ~J? ~
~T ~ r+~ v ~ , iR.1s~. and I reside at /D a / ¢v1 oZ .
~ l8te+~t ~d NmD~rl
~r F/.g . , sT. ~UG ~ E~ co~,nc,. ~foaa..
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and this statement is to be taken u nq? deelaratjon oi eitixenship. setnd kg~l t~esidenee and domIcile ia tbe State ot ~'Iorlds.
if POR THE PURPOSE Of ENRO« ING ~ IP iOR 110MESTEAO PURPOSES~
CHILCREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~
THEIR NAMES: '
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0 M~~'E OE~ _r-
fT. ~If
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_ ctE~~c ~~„~v,T cou+~t
Rf~OR~ YEF.tilf~~~
~ Aa~ 19 i io PM'75
- - 3~S"'780 .
I FURTHBR CERTIFY that I w~l register at my local address whea the registration books reopen. and oompt~ with all .
other requirements ot a kgsl resident of tbis State. . ~
I FURTHER CERTff'Y th:t I have no intention to retura to my former domieile. and I intcad to re~nain in
~,T c rc~ , ST . L UC 1 E , Couoty.
«;~y~ .
~ Florida. permanen~i~ .
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(Addrwl
g Sworn to and subscribed betore me this day of ~ i" L7 ~~h
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~ .D.19 7S
~ ROGER} POI S CLERK OF . G IRCUI T COU2T
~ ST. LUGIE COUNTY, FLORIDA .
~ ~
~ BY:
~ PUTY LERK BOOK243 ~~E ~V2
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ACO Forai Tt •2Z
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