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HomeMy WebLinkAbout0262 uec~araitvn vT uvm~c~~e ar~u ~~~cc~ ~~R ~~N , . ' ~ ~ ~ f . ~2,~~~ ~ TOTfIE CI.EItK OF'1'~lE CIRCVZT COURT. 1 ST. LUC t E _____,o0tlN1'Y. FtARiDA: . . ~ , : . , ' ! 11h b aq? d~etarattoe ot Don+kit~ Mnd Citisee~lp ta tM 6tat~ oI Fxida tbat I ua ttttas tl~ls dy? io soeo~daaa. and 1!~ . ' eoa~ormity Mith Sectioe~ 222.2T. Fiodds Statutes. ~ ~Y(..62. /AA~,I~-Cl~ ~ • t was ~ a k~s! t~esld~t ot a---------+ aad I ~ ~It~,fl ~ tae~l te~id~dat._ _ / t>> f' . - Sow~wrt. I 6aw ~hanrd aq? domiab to ~w..e..~N..e.~ I J~~U~ l q'~ wd as ~d luv~ beea ~ boaa Gd~ raaid~nt o~ th~ Stat~ ot Flocid~ doo~ _ / da~r at „_,.=.1l~. aod I raid~ at ~ . . ~1v1-~.- 4 ST. LUG 1~••a~ ~t~. Fiorida, . ~ • aad !bb statemeat b to b~ Wc~ a~ aq? de~ratfoa ~ dtisea~p, sctad k~a! sa~idenc~ ~ed domia7s Is t1N Stat+~ ot Fiorida. . IP POR TH~ PURPOSE Oi ENROL~INC ~ IF POR NOMESTEAO PURPOSES CMIIOREN IN SCHOOL~ PLEASE STATE NLt~SE CHECKS ~ THEIR NAMES: ~ . , . " filEO A!i!~ ~~C~R~EO . ST.liiClC C4UN~Y FLA. . ROGEP. ?3!'RAS ~ . ' CLERK C~~~itlT COUttT ~ RFr.o~~ rFFrftEO_....,_.. ' . . OEC 19 li Ze AH'75 ~ ~ . „ - _ = ~ ~ ~ 323`,~$ - I FLJ~iTHER CERTIFY that I aiU cegister at mp local address whca the registratton boolcs reopeo. aad oomply ~?ith a11 ot6et requirements ot a kgal cesideAt of this State. ~ I FURTHE~ CE thit lµ~rs ao intcntiou to return to mr former domicile. aad I Intrrid to remai~ in ' ST . L U C t E . CountJr. l 1 . ~ Fiorida. pernuneaci; . • ~ ~ • - - ~ 1 I,•~~' : . . a . . ~ , ; o S ~ Z.l :i. . . - ? ! g R ~ ~ ~ t1 . ~ .j ~ ~'~G~~,, ~ ~ . . - y / . ' • y';;f,; i c~~i ' , ~ " L k~0 f..l _ . . , in. ~r - ' ~ Z,,`~~a:,,'~lt ~ ' Q ~ ~ • INaa~s1 f ~ ~ • ~ .,r • ~ ~ ~ ~ ~~i~5 , ~ . '``a`t~ ~ . ~ ~ ' . 6woftt to.imd,y~~stnboi~~Iora me this ~ _ day oi ~ . ~ . ~ ~ A.D.19 r - ROGER PO)TRAS,` CLERK OF CtRGU1T COU2T ~ r~~~ _~~~k Cou?+T- , ~ r.(~~'P kc e~ ~=1 4_ ST. LUG 1 E COUNTY, FLOF21 A 3 3~-.s7J BY s o ~ . EPUTY LERK ~247 P~ • . ~ , , . ~ . . . ACn ~'or~~, 71 ~ ~ ~.,y x`+, s-y r ~ i _ _ia- ~r~;~-~~r`~-~' . ;t~ _ , _ `