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Home My WebLink About0640 Declaratian of Damicile and Citizenship ~ ~3~~ ~r)F i,`~ TO Tlit: CI.ERK 0~ TIiE CiRCVIT COURT. ST. lUC 1 E ap~~~ f't,p~1DA: '!'Ab M wr decbratioa o1 Doaucile •nd Citis~esAip ia tbt~ Sut~ ~l Fbr~da tl~at t ua C~4at chis dar i~ ~ecorda~a. ud ia ~o~tormiey .?icw Section ~2.17, Flonda st.cnth. l ~l"1~~Gt~G ( IlL~~A~~t'Q_- W~l ~ ~?Y ~Or1Brt~ ~ k~a~ f'lfidfQ! O~ - - ~if iWl ~«.w re~idcd at 1- 1••~' Gt - Heweve~. I Aaw cbaa~ed m~? doa~ie~ to ' ~ tet~.a..~N.r.H a~d ua ~ad Aaw seaa ~ bo~a fid~ cesideat o~ tlN Stat~ o( florida su~c~ ~y? o~ ~ u~d 1 resid~•~~ 1 ~ _1 tt ~t _ ~ { f C~- . t~en+t a.~ N~~Mrf ~ r 4 ` ~ _ ST . l UG I E Gw,~y~ F1o~id~, . ~v~ trsd tt~i~ ft~t~eat ~r ta 6t t~-?~o r~ a~y ~iarat:~u ~t ~;t~~~up. stt~a! 1e~a! res~e~ ssst! dcmi~ f~ t!~ Ss,at~ o~ Flaids. IE i'OR TH[ ~UR?OS[ Of ENROIIING Ii /'OR MOMESTCA~ ?UR?OSES~ CHILOREN IN SCNOOI~ PLEAS[ STATE ~l[AS[ CN[CK: ~ TME IR NAM[St ~.~~~~.1~iC! _~~i i~C' Ll' i f L~ j ril! C • ! ~:;KOiO ET :J;,. ..::,Mi? il1 cC. ~ - -~lS • ~ L~ ~ ~ ~ - ~ C:u~T . . , 1~ - - - - _ Auc Ib 1 ~9PM'ib ~ ;3'~~~~2 I Ft1RT11f:R CERTIFY lhst 1 wili reRistcr ~t mr bcal addres~ wAen ti?e regi~tration books reopea, and compir .rith ali other ra~uircmc~ts o( a legsl res~dcnt of th~s 5tate. 1~L1~IIE:Z CERT PY tA~t 1 hsve no intrntion to return to m tormcr domicik, aod 1 intcr~d to rcmain in r~~~ 7 ~.c-~- _ ~~_~UC 1 [ ,County. ~cn~~ . Fb~ida. pcrtnantn~i~ . . i E r f S E r'~. j) • ~ ~ .r. ' - ~ ~ ~ _ , ~H.~,,.~ ( r p ~ . 4. t1 [ • i~ C ~ .JC Q c .lAWrwl _ ~ . S~rorn to ~nd ~ul,scritKd tx~loro rrM thi~ ~ day oI : u:' ~ ~!l r i~ ~'l.i 7. ? ' ' ,A.n.19 7f' - . RQGF~R PO AS~_CI.f.RK 0~ C iRCUI T COU2T ST. LUC i E COUNTY, F LOf21 t~A E3 Y t ~ PACE Lh+~/ ~ t ~ ~~~utx l[RK ' l S '