HomeMy WebLinkAbout0637 D~clara$ion o~ D~mici0e and Ci~iz~nship ~
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TO T11E CL~RK OE• Tii~ cincurr covn~r. 32~1~32 ~
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~ ST_ lUC 1 E (,p~,1NTY. FI,pR1DA: ~ ~
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' Thb b anr dcela~atba o~ Aomicib and Cit~onsbip fa the State of Ftorida that I~m GUu~ tAta day ta ~ecordanee. at~d ta ~
~oa~o~miyr with Scctioa 2~.17, E'brida Statutos.
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~ I Mi~ ~A~IIM~~ ~ I!~ !Ql~QAL O~ Y--- ` M~ I
tasided at M/}~ Howe~e~. I bave ehaaaed my domicilo to
„ - l8t~wt a~d Nws~l •
-S~Pr' ~ /971~ , a,,?~c
u~d am and have bcca a bon~ Cdo resideat ot tho St~?to ot F'to~ida sic~ce
-19__.. and I resido ~t / lSI ~ J/t'?'l~/t~i(/~,S ~l QiZ I ~/L~
~ lSt~wt ~ad N~mser!
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I l~ /3 ~ C~ f _ ST. LUC 1 E Countr, Florida,
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aad this statemcnt u to be taken as mr declaratioa ot eitiun~htp, aetual kgal n~idenee snd domicile ~e the Stato ot ~'lorida.
If fOR THE PURPOSE OF ENROLIING If ~OR HOMESTEAO PURPOSES~
CHiLOREN !N SCHOOL~ PLE/15E STATE P~EASE CHECKS ~
. THE1R NAMES:
11.E0 AMC NECOAOfO
~ ~1. Rp~~~~C?OIfRI?S~
. RF~QP.O ~ER'f ED ~~URT
~ ~ ~ 30 1136 IIM'76
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~ l FUR7'IiER CF:RTIFY thal I wiU rel;~istcr at my loeal address wtien the re~i~tration Look~ ceopen. and eom~?ly with All
j othcr rcquircments of a Icgal resident o[ lhis Statc.
~ I FURTIII~;:t CE[iT Y t~a4 I I~ave no inlc ntion to return to my formcr domicilc. and I intcnd to rcmain in
~ . u f2 t/~[ZC.~ , SY . L u c i c , Cou~~~r.
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I~'brida. pcrmancnti~ . ~ '
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~ Svyocn to ancl ~ut~r.cril~~d hrtoro mc li~i+ dny ot
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Rb('j~R !'n11RAS. Cl_FRK Of C~IRCUI T COURT •
ST. LUC i E COUNTY, f~OR 1 UA
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