HomeMy WebLinkAbout0138 . - ~ • • • s
De~l~r~tion ~f Dc~~cite and ~~tsz+en~h:p
ro c~sx oF THe cu;cvrr oo~RT. ~'33214 f~ .
ST. LtJC 1 E OouN~rsr. FLOaIDA: . .
Tbls is rnp daciaratioa of Domleile aad GYtisenthtp ta the State d Florfda that I am t~ina tbb dq in aocord~nos. and tn
co~atormicy .ritA SeetIa±i 222.17. Flarida btatutes. '
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I was torn~e a kgal rosidaQt ot ~3uJ C_aT r. _ , acd I _
1~ 1~71
resided at v,T o~ Y, r~_ ~ - Howevee. ~ bave ehanged ayr dotni~ils b ~
- (Bt~wt ~d AI~~1 ' .
atid aan wd have beeu a bona Cde resideut ot tbs State of Ftorjda si~s lr ? ~ ~ dy? oi
_ ~.19~2.. aad I resids at ~ 8 Z ~ j-= ~~ras~, e~r `e .r'~
~ (St~+~t a~d Nu~D~tl
~h,~,{- S'T . LUC 1 E councy. Flaid.. ~
lCK7!
aad this statemant is to be taken as nqr deelantion ot citizenship. actuallegul residenee and domieile ~ 1be SLte ot F~ocida.
~f POR THE PURPOSE ~P ENROIIING IP POR HOMESYEAa PliRPOSES~
CNILDREN IN SCNOOI~~PIEASE STATE P~EASE CHECKS ~
TNEIR NAMES: .
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~ FILfD ~lti~ qEi.~RO~
st ~a~~~r a
RGLE~ =~!'A~S '
, CLF~cK C:rCJi3 COURT -
. • . . ~=SCF~ vEF~FtEO ~
~ AtR 11 IU z0 ~'16
! - ~ - 3321 ~ ~
; I FURTNEB CERTIFY tlu~t I w~71 register st my local addt~ess when the regittratioa books ra~en. ~nd comptp ~?ith all
~ other requirements ot s legal nsident oi this State.
~
I F4R17 ~ C~FY ihat I have ao inteotion to return to my former domieile. and I intend to remais in
e~c`'t- ~ .~..~i.~ , $T . L U C 1 E , Countp,
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~ Sworri to ~r~ subser'bed bciore me this ~ da~ ot ~
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~ - - ~ A.D.19 ~ 6 -
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~ F?UGER PO AS, GLERK OF ~.IR I T COI~tT ~
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