HomeMy WebLinkAbout0977 Dectaration of Domicile and Citiienship
TO T11~ C1.ERK OF T11E CIRCUR' COURT.
ST. L UC 1 E pp~~. }~,p~DA:
.
'!1!~ b m~ deela~atbn ot [)omic~ and Citweu~eo ia the Sut~ o~ Flor~da tAat 1 sm Glias tAis ds~ ia acc~daae~. aAd iA
~.~t~naicr .teA S.ction :
:.t~. F1or~da stac~ces.
1 w rnxrl ~ ktal re~dent o/ .~r J V ~ t X - • l~ - a~d 1
. 1 1lvtN
~wW~d at ` j h%-1 ~ f' f-~~ 1, 1, L i- Ho~w~er. I Raw cAansed mr doaueJe to
1MnK r! N~MrI
Yd WII ~t1d I1a~f 0l~fA ~ ~OM C!d! Plfldltlt OI lIl! S~ll~ O~ F~IOtI~ 11Q~! f ~ t~' ~ O(
r
_ ~ f ~ ~ ~ ~ _ ~e r u _"t~ l 1 ~
c..x ` ~i 1 , i c . ~ K ~ :,~,,,1~~
~ t~uMt ~ N~serl
_ 1 1 j'~ c~ ST ~ l UC 1 E Count~. F1o~a,.
~
~ay!
ud tAb statement is to be takea u s~J declar~t`oa ol atiua~A~p. actual k~a! res~dee~ usA domieJe in tM Statc ot F'londa.
~i rOR TM[ rURIOS[ Oi ENROIIING ir rOR HOMESTfA~ OUR?OSES~
(NILOREN IN SCMOOI~ P~[ASE STATE ?t[AS[ CHECK: ~
T N[ 1 R NAME S:
~
_ ~ } ) . 1_ Y ~ F I ~ ~ ~ t ~ ~ ~
\
'
f .i, ia ~ .Yt`J '
ST U. ;s'r iU
~ - P. s ,i~~ ~
r~~ . ~
.
Auc i~ ~ ~ vv AN '~b
;.~~7~
1 FUftT11E:R CE:ItTIFl' tAat 1 w~li reR»tcr at my locai ~ddress rvhen iAe re~stratwn books rcopcn, and campir w~tA ail
oli~er requiremrnts of a i~~rl n~s~dcnt o( lh~• ;tate.
1 PURTlit:3 CEFtTiF'Y that 1 have no mtcntion to rctu:n to mr formct Aom~cde, and 1 ~ntcnd to n•ma~o ~n
_ ~ ? / f 1 f ~ , S T . ~_u c L Cou~?~r.
~ca~t
i
~ i'lor~ds, permaa~nti~ .
:
~
~
s
t
's
[
S
{
~
t
4g
F
: ~
€ . ~ ~ i• • ~,I ji ~
t ~ _ / ` ~~r l ,
f
. _ • ti ~x~
• . . -~_/f _ 1 ~f ~f5!' 1 ~1 / . . .f\CA .
~ J . ' .
' . ,'s ' ~ . * ~ ~ ~ (MAe~s~l
SM?~ta.iplad subscriM,d t?rlorc mc thu day o( 1 r _f~y ~
. . ~
% f t-~<<.= fi . A.1~. 19 ~f,
- RQ~ER P01 YR_AS, Cl EF2K OF C I~2CU1 T COU2T
F ST. LUC 1 E COUNTY, F LOk 1 UA
= BYt ~
. ~ c
` [PV1 LERK
~ ~ ~ 2a~ PAi.E ~
~ '
~
,
_ ~
;
~z ~ ~
~x~.~,.._. ~ . ~.-r~