HomeMy WebLinkAbout0127 ~eci~r~#i~,n of D~rnicil~ and C~ti~~n~hip
TOTliE CLERK ORTHE GIRCUIT GOURT. •3321
ST. LUC 1 E t~ourrrY. ~'t.onm~: ~ •
T1~is.b npr declaration ot Domicile ~d Citi~whip in tl~e State at Florido? tkat I cm t~In~ this da~r ia acooedanee. uad in
coatocmity wtth Settlon .",22.19. ~'lorida Statutes.
I waa t~ a legat restdant ot ~~~~p -~'`~~'"~'v aod I
~ ~ lBt~W
~~t Ao~revee. I have e,~anged a~ domie~~e tn
I aa Nw~1 .
and am and hare beea a boe~a t~de resideat ot tLs State ~ F1a*ida siaoe ~
___~A~ G/~ J, iS 7~ aad I i+c~ide ~it _ ~
. ( s~d l~f -
ST . LUG I E co~,,,tT,
taa~ . - -
aad this statement is to be taken ss my decluatioa ci dtiuwhIp. +~dnal kgal raidenoe and d~~nkile in tbe State ~ Florjda. ~
IF POR THE PURPOSE 0~ ENROLLING_ ~ IP FOR lIOMESTEAO PURPOSES~
CHIL~REN IN SCHOOI~ PtfASE STATC PLEASE CH~CK:
THEIR NAMESS .
_ ~ , -
~ r? a ~ ~t~-4~~ - ~ ~-~C+--~~~-a-'~.~-
- ~
~ f~~ED ~N~J RECO~pE6
- ST: LUGt£ COUNTIf FLA. St
- - fiOCEP ~41TRAS
CIEkR Ct%i~WT CJU11T
. - P.E~Oz~ 'rE~if~E~J
- _ ~It IZ 10 02 ~'70
_ ~ 33213~~
I FURT~IER CEItTIFY that I ~n71 register at my local addnss abea the registntion books nopen. and comply with al!
,
other requireraents ot a leg+l resideot ot this State.
i .
~ ~ I FURTHER ~R~T,I,
~'Y I hsve no intention to return b my tormer domieile. aud I iaLend to reau~in in
~ • j~M~G ~.,~A ~v ~ S T. L U C I E . County.
~
' Itks~) . .
Florida: permaneoti; . - ~
-
~ . u~~'...~EOU .
: . ;
J~, ;~G~jx yti.
t,
~7~, . ` ^
`t-:.y' J _~S " : ~
" ~ ~ ~ . 2! ~ .
't' ` • -
. Z~
~i ~X++~,.~'S V
~ ~
t~. ?;.r' ~ .
;r~~ ~
C s~?• ' . ` ~/`-C-e~-f.-C~t/
r~~
~ '°••~•..~...,t*,..~" `
= ( ) _
~ ~ ~
~
Svrorn to snd subscr~'bed b~[orE me this .~~day ot ~ ~'L~'? w- ~X- °3~`~`~~
~ . _ ~
~ . A.D. ]9 76 _ -
E f
R4GER I AS CLERK OF' C{RCUIT URT
ST. LUG 1 E• COUN't'Y, F~~R 1,UA
~ - BY: ~ , ~'1 Gt
~ f ,'__~P u T Y i a K
~ ~ . - F z~~. ~ ~ -
~ ~ ~c~~~:_.-
~
, 3 ,z
_ ~t~~-~ g?~~ _ ~ aj~~