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HomeMy WebLinkAbout0268 ~Declaration of Domici~e ~na ~~ZlZensr~~~ . . ; . ~ . ~ ~ . . ~ 323`~'??4 1 ~ ro~c~coF~crncurrcocnrr, ~ . ~ ST. Ll1C 1 E COVKrY. ~`LOnnm~ • t '11M b my decVhtioa ot Danki{s sad Citiseaskip ta tM 6tat+~ ot ~'{orida thai I ~?m t~at th~s d~ tA aooad~na. and ia aootoemity ~?itA Seetbn 222.1T. I~'lorida Statuta. . S~rR~v~S/~v~ec _ f'~ ~ .pdi i ws~ ~ e'a~id.s~t ot ~ I~e.ai ' Rr~ 130 ~c ~ ~ ~ _ xo~~?K. te.~?.~ ~r ~ ~ ,~a.a.c ,~..~„•N,~, • 19 ~ d.~?ot asd aia aad baw beea a boaa fid~ ersid~ot ot tM Stat~ ot F~ocidasi~oe~ j~ ~!R ~ ''=1l~_. aod I ersid~ at y~~v Tv~Q ~ o ~ r ' ~8ei~t ~ Nw~bKl R~ J~Eivs' ~ rv /3~~cH ST. LtIC 1 E Coaat~. Floricta. . taar ~ wd tWs ~latement is to bs W~~o a m~? dettsratbn oi dti~enshjp. aetwl k`al ra~ideaos aad danidie in ehe Sta~s ot E'Iocids. ~E FOR THE PURPOSE Of ENROLLtNG IF FOR MONESTEAO PURPOSES~ CNILOREN IN SCHOOL~ PLEASE STIITE ~~EASE CHE6K: ~ THEIR NAMESZ - ' s . • . • ROCER P04TRA3 ' ~ ClElill CIIt~u1T OOWiT ~ ~ , . - REC~R11 YERiilED ~ ~ ~ ~ ~ ' DEc 29 ~2 ii PM'15 ` . ~ - 323'7''~'4 . . ~ j FUKTHER CERTIFY that t~?~1 n~ter at my {oeal addresa whea the re8i.+tratan books rcopen. aad ootnP~7 rrith all othes requinmeats ot s tega! resident of this State. . - ~ I Ft)R'rHE3 CERTIF'Y tlut I have no intention to return to eny former domicile. and I tntead to remaia ici , . TEI?f~.~ /3~A~H $T . U C 1 E - County. ~ (Cit71 . ~ - • 4 Florida.. pertaanend; . . ~ - • ~ ' , $ . ~ - ~ - ~ - . . ~ cu~r , - ~ _ - = ,;~i-s••'-~.`'.w~~ s ~ ~d~~~/ SrE/'1 ~ ~;"9~ = . . . , =i; y ~ . • ~ ~ . . • ~ ~ ~ ~ _ N ' !•4~ ~ M " ' • - ~ r~:~~~ '.~-..s~' ~ ~ • ~ ~ ; • ,~~F' • ~ • ~ - ~ O . ~ . 1.:!;: ~ ~ ~Q ~ F~ _ ~ r. . . ,,,,C/F 0 . ~ ' ~ned'..'~ y C , ~ Sworn to ~nd ~ubu~Ibod bctoro me th[~ ~~y ~ . ~ ~r~ ~ / JC P iji P/~~..~ _ A.D.19.:i_~~ ~ . ~ ER AS CL RK OF CI UIT COU2T . ~ ~ ~ ST. LUG 1 E COUNTY, f ~OR 1 UA ~ . ~ 8Y: ~ ~ . PUTY ERK O R ~ , so~ 24~ ~ 2 . ~ . ~ ~ . . . . t~~~~~„ ~t~ - f _ - ' i , Y""_ ~..',~S_',;..,r - . _ __d~r,.~~,.__. . _ .