HomeMy WebLinkAbout0553 Declaration of aomiciie and Citizenship ~i ~
TO T1lE CI.t:(tK Of TiIE CiRCUIT COURT. ,
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ST. lUC 1 E aputv't~r. FT.OIUDA:
'11~b b my deel~ratioe ot nomicib and Citiscns~ip ia tAe ~tate ot Fiorida tlut t ua Glins tAia dyr ia attnt~d~?nu. ~nd ta
~ontormity aitA Scttia~ ~2.1T. F'brda Sletutrs.
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1 w~s lor~ ~ k~sl residtet ot ~ X=~ ~ L~l~f , { ~ ud 1
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` l I / C!!S t-/i~ - No~w~?et. t baw c my ~ile 10 ~
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18tnu ud N~1
ud aai and b~ve Seeo ~ ba+a C~de ro~idsat ot the Stat~ oi Flofids s~ncy 1 c/?~ ( ~
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.19 ` ~nd I teside at '~,j -
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~ f, ll'. ~ 1 i ~ ST . L UG 1 E County. Florid~.
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~ad tAb statemeat i~ to ~e taken as my dectantioa of citizenship, aetual k6ai ersidenee and danici{e in tM St~te oI Plorida.
If POR TH[ ~URPOSE O~ ENROIIING I~ ~OR H01lEST[AO PURPOS[S~
CHIIORt~I IN SCNOOL~ PL[AS[ STATE ?L[AS[ CNECK: ~
THE 1R HAMES:
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~tlti ~EC~RCEO
ST ~l:'' ~Uk'? ilA
c'+ . 1t: i.udAi
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Auc 16 i2 3i PH '76
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I FURTIIk:R ('};}{TIF 1' that 1 wdl rr~~+trr st mr lacal ~ddress when the r~g~stration books rcopen, and romplr a*ith ~II
olA~r rcquircments o( a ir~;al resul~nt of thi? ~tatc.
1 t'U1~Tli~:~t (;~:f~TIF'1' that t havc no ~ntcrstion to return to mr form~~r dum~c~l~, •nd I~ntcnd to rcma~n in
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L_u C 1 [ Couoty.
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Sv?orn fo rnd suL~cr~l~rd 1K•torc mc thi+ ~ d~r of
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ROGE'R f'OITRA'~~~Ct f~lK_nf _C IRC,IIIT COU2T ~
ST, t_tK 1 E C~ur~TY, r~n~~ ~un
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