HomeMy WebLinkAbout0245 ~ ~ • s ~ .
D~c~ar~?tion of ~~am~G~~e and ~~t:zer~shi~
~
To ~i~ ct.~ruc or ~ cn~cuiT oourcr.
~ ST. lUG 1 E oourrr~r. ~A~o~:
Th~a b aqr declsratioa ot Dowicib ~ad Cit:izoaship Ia tbs State ot Floclda tbat I am i~ tbi~ ds~r ln aooordanoe. and in
ton(orndty with Seetioa 222.IT. Fbrida Staintea. • -
I w~s t~ a kgal resideat ot ``'a'~ f 1' ~ en ~ ~ t-l ~r . C( C,~~ aad 1 ~
~ ~~y) l8t~a1
resided d ~~t ~1 5 tfUQ.l!(:t ~ Q - Ho~rever. I bave ehan~ed aqr domiple to
(StrMt Nd Nooeet3 ~ .
.~a.m andt n.ve been a booa f,ae ces~deat oi che ssate ot Florida.iaoe ~ ~r , 1 ~l 5'~ da~, ot
l ~iC-~ ' . ~
_ , _ ! 19 . and freside st ~
• 1seeMC a~d t~lw.~a)
_ ~ r :.~v c ST . l UG 1 E Count~. ~'locida. , ~
tciv) -
snd tkis s?tst~aeat js to be takea ~ m~r deeluatioa ot eitisenship. ~etud ksal resido~e and doenidle ih tUs 3teb ai FforFds. _
IF fOR TNE PURPOSE OP ENROLLiNG ~ IF fOR HOMESTEAO PURPOSES~
CHIIDREN IN SCHOOI.~ PCEASE STATE PLEASE CHECKS
THE IR NAMES. _ -
_ 3322p; -
it~f0 RMp ~tfCpRpE0
- ir. lilC~E COUNTY fLA.
~ - at~ccz ao~T~~s
cs.EPK :~u~T cauR ~ -
RECGA~ VFf:~~F~
~ ~ Ar~ i j I sl PM'?6
; 1 F'[)RTHER CERTII~`Y thst I w~l register at my loca{ addre.sa ~vhen the registration books rcopen. and oomply ~vith ali
, other requirements of a legal resident of this State.
i
I I FUATNEu CERT~~ tl~tt I have no intxntion to retura to m former domic~7e. snd I iatend to remaia in
~~'c.~f - t' ~ o r«~ ~T . L U C I E . County.
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Sworn ta and subscribed heforc me this _,L_°`= day ot ~ tv ` E+~-~ ~ ~ F} •
- ~ - A.D. l9 7~ -
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R4GER P4 I TRAS.: '~d.~Q'~._OF; G.( RCU 1 T COUR T
ST. L...UG I E COt7 rl~'['Y; ~y'f COR,1'tJ~i~:.
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