HomeMy WebLinkAbout2141 • . . . r • • ~ / ,
Deciarat~on .~f ~om~c~te ~ and ~ C~t~zensh~p
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TO THS CLE1tK OF TH~ CIRCUIT C4ZJKT. 3i~ a3
ST. l.l.lC I E ~~-~ry, FI.ORIDA: .
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Tfus I~ ai~ declarstioq ot I~oniicii~ and Gititership ia the State of Florida tbat I un Wtag this dq ia ~aordanee. aad tn
eo~iormity. rvit,h $eciioa-'..:~~1~. F#~dda S4wtes: .
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I was io~cr . a +~d t `
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tesided at ..,:;.:;L S= ~ NS O~ - Ho~rever. I bave e~anged uU? domlcile to
, ~ . . _ ~ _ = l~tn~t ~sd Neo~b~ .
and aat srtd have 6een a b~a Gde ros[dc.
n~ ot lhe State ot Florida sines + ,Lr, d+U? ct
- _ - ~ .19 ~ad~ reside at ~~Q /~I~~ •
~ (&rwe Nd Nrmbr)
~'F~e £ ST. LUG 1 E ~w,.
aad thi+ s~i{ement is to be takea as m~? dec4ntioa at dtjsenship. actwl kgal reaideacs aad domieik ~a tl~s Stste ot Fiorida. t
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Ii iOR TNE PURPOSE OP ENROLLING IF FOR HOMESTEAC PURPOSES~
CHILOREN IN SCHOOI~ PIEASE STATE P~EASE CHECK: ~
THEIR NAMES2 ~
,J ~:,y ~v ; ,e r~iu a cv rtJ
~ FIi.EO A~t3 AECQRDED
ST. LUC{E COUtlTY FLA.
ROS£: Fv4iRAS ~ '
C! ERx G+~iCtllT Cl?ftRT. t
qFr,r~., yr;.:>~ED
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Y.
- , 33.6'7'~3
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I FURTHER CERTIFY that I will register at my local address when tbe regisLration books reopea. aad compty with a1i F
other requirements o! a legd resident of this State. ~
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I F'URTHE~TIFY th~jI bave no infxntion to return to my former domicik. and I intend to remain in ~
~`.~.~Gt~t .r• Q_ , $T . L U C 1 E~ County.
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Florida. permartenu; .
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Sworn to nd subscribed betore me thia _~s day oi ~SO
: A.D.19 ~ ~ -
ROG R PO! TRAS CLERK OF C IRCUI T COIJ~'2T
ST. LUGIE COUyTY, F~ORtUA
BY:
E UTY LL'RK ~
~ eoox243 PacE214Z ~
~ AG(1 Form TI 22
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