HomeMy WebLinkAbout0665 V~v1~711 ~~fv~ t v~ vv~a~~v~~v a~ ¦v v¦a.~~. ¦u¦ ¦¦M
. . 31~?~3.
TO THE CLERK OR THE CIRCUIT COUIiT.
ST. LUC 1 E ppUiv'rY, FLORIDA:
Tbb is a~ deelar~tioa ot Domieils ~nd Clt#~en~blp ia tbs &at~ o[ F'Io~ida tlut I am GW~ thts dyr ia aooocdsaee. sad is
eoatonait~r nrlth SectiQU 222.~7. Flocids Statut~s.
I was !
r~+e~l ~ ksal resident ot ~x~ l. . ~ Na.•~ 1 o~w aad I
. iGV1 ~ata~d
ns~kd at ~~ill~u - Hawever. I bave eh~nged m~? domia'Is to
l8en~t a~ N~wbKl ~ ~i
and am aad have b~en ~ boaa Cde resident ot tAs StaLe ot F?orida sinos dqr ot
C1 s+X ,19 h 4 . and I raide ~?t ~ 1~ ~~ua,r~ U~'W ~ -
- t»~t aed l~l
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a~ tbis ststement is b be takea ~s m~ derlaratioo ai eitisenahip. aetual bgal resideaos ~ad doaa3eib in tAe 3laLo at Flocida. ~
IF fOR THE PURPOSE OP ENROIIING Ii iOR 110MESTEAa PURPOSES~
CHIIbREN IN SCHOO~~ PI.EASE STATE PI.EASE CHECKS ~
THEIR NAMES: ~
~~~E~ R~COROEO •
~ St. lUC1E COUMTI? F1,A,
. . • ROCEi POITR~S
- CIERK C~RCUIT COUAT
~ RECOan vcn~:,r..~~ _
- Auc 19 I . 40 , ~
?H 75
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I FUR1'~iEB CERT~F`Y that I~1 register st my local address whea the registration books reopen. aad oomply with aU
ot6er requir~raents of a kgal resident oi tbis State. ~
I FU E~ CERTII~'Y that I have :.a e.~•~ntion to ntura to my forme~ domieile. aad I intend to remain in
~ ST. L.u,e.i~, ST . L U C 1 E~ . County.
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Florida. .Permanen~i; . ~ •
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Sworn to and subacribed before me this day ot ~sv~ 51 ~~a •
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F RO K OF GIRCUlT COU2T
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