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HomeMy WebLinkAbout0978 Declaration of Domicile and Citizenship ~ TO T1tE Ct.ERK OF TI IE CiRC'UIT COUR'f. ~~,~79 ST. lUG I E pout~n'~r. FI.ORlDA: ~ ~ 'cw d ar eKu~.~~«? ~t t~~w .~a c;~~~.ero su~. ot F~o~a. u~.t t.,~ c~ d.~ .«ora.~.. sad ia ~Of19t~r MI~~1 .~l11011 ~.a~...17. ~Of1d~ Sl~lYlff. 1~ras rl ~ k~al resd~M of ~ asd I , {C1V! Iit~tM re~Wed ei Heww~t, t Aaw eban~ed my dwn~ak to NN..~..~ N..~.•1 ud am ~nd bav~ ~a ~ soeui C~de resdeet of tl~e Stat~ ot Flond~ s~en Jar d 1~___.`., and I nsid~ st (wMt rd N~slR! ST . L UC I E couoey. ~v~ ~ad tl.is stateaneat is to se taleea as my drelsrataa o( ntiseealup. actwl k`~l re~idaoes and da~ucile ia tM Seate o( Plo~d~. ir fOR THE ~URrOS[ O~ ENROLIIHC 1~ rOR NOMEST[AO PURPOS[S~ CMIIDREN IN SCHOOI~ 1'LEA3[ STATE ?l[AS[ CH[CK: ~ TMEIR lIAMES: i { • ? t `J . k~ f i t . . ; - auc i~ v~ dM'lo :',~~'Z?'7J I FLIKTIIE:R CF.(ZTif 1` that 1 w~il rr~~~tcr at rriy local addnss when the r~gisttatwn books ~coprn, and complr M~~tA ?li ot!?et rrqu~rentrnts o! a M~;al rr~~drnt o( th~~ ~t~te. i 1 FUliTHE::t CE:i{'f'iF'1' th:t I hive no mtrnt~on to return to mr tormrr dom~c~i~, and 1 intend to rem~in ~n t ~ S. T a~- V~1~ County. IC+~~I }'btida. ycrmanenti~ . i S i t ~ . ' ` ? • . ` ' -a . • , ' j, s. . • 's - - - ~ INaawl ' ~ (A~fnwl Sworn tu and subscntMd M•fure mc th~~ ~ d,r ot r ~ 1 t~ 1 ~ ~~l ri~ ~ l.~~'f' . A.D. 19 ~f' . ~ 1 ~fR PQ1 ]RAS„__C.l ERK ~F C IR_C.UI T COU2T ST. lUC ~ C COU~~TY, F L.O~< t UA - BYt ~ ~ ~ r. ~ . _ ~ C , Y ~ x , ~ . ~ ; 256 E~= : z _ _ ~ ~y r-,~r ~ r _ . _ _ ~