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HomeMy WebLinkAbout0653 _ .R . • D~ciaraYi~~ ~Y ~~micil~ and Ci~iz~~shi~ . ~ . 35~4~~ TO TNE CI.~AK OF THE CIRCUIT COVRT. ST. lUG I E OOtlrrr~r. F[ARmA: T!?b b mr deetuatbn ot Domieilo at~d Citiscn~hip ia the Stato oI Florida tlu~t I am tillna this dqr ta ~ceordance. aod in ~oatoraaity Mith Seetsou 2?2.17. I~'lorida Statute~. I w~s t orl a k~al reaideat ot ~~,e/2 C F S TE~f ~ ,/Z%~~/~.~ .S • and I . IClyl l8tatd e+estdea ac _ .~rrw/ ,~v~ . - No+.ever. i Aa~e ehapged mr doraidle ~o 18v+~t a~d Nrs~1 ~ aAI iDd AtYO bEQi! t~~ i'!!~!'Dt Ot ul! ~S1iLQ OI FIOf'Ida 3i11tO S IE/~ T / ~ir 0~ , ~ r f ~ ~ i~2,~..~ai ra~,~t ~ / S- Ts~~ ~i~i~?> t~~f . l~/~/t C' ~ ST. Lt1G 1~••aN,~eK~ County. I~'bria., lCU~1 iDd ~II3 i~ttIDCA~ IS t0 ~iIICO i1 Q1~ dlCliTitI011 O~ CIUZ!!1l~IIp. aetual kgai nsidcnee ud domicile ia the State of Fbrida. If FOR THE PURPOSE Of ENROLLING IP FOR NONESTE 0 PURPOSES~ CHII~REN IM SCHOOI.~ P~EASE STATE PLEASE CHECKS ~ TIIE tR NAMES: . ; ~T~I~IC E COUNT1f~t~A. a IIOCE~ F~3TRAS dfRO YtR FIEO C~RT v RE ~ W ' ~1~ - 35?~4'7'7 I FUEiTNER CERTIFY tbat I wili ngister at my loca! address when the registration books reopen. and eomplr with aU i otber requirements o( a kgal resident ot this State. i 1 CERTIFY t~ I have ao inteation to return to my lornxr domiG7e. and I intead to renuin in ~ ~iF.~` ° ~ , ST . L u c ~ E . C~o~r• t(St~) . Fbrida. perananeati;. . ~ iN~~R~~~N, . ? - ,j :~e~I,`~~'ao~i ? - . • ~~_=fif. ~ .~l:~' ~ . F ~ r/.' ~ , s~'ts :_4 : ;,~s +~,7~ : _ i / i ' ~~j`, ! • y ; ~ - ~ ~ ~_.^im- ~ ~V ! \ //7/- ~ ~ ~d.~ G ~ ~i ~ .1~ r _ ~ ~t~'. _.t, . .r- M~~ SL - . ~ , / S~ % s9~`9 ~t ~ . : f_ . ' ~ . ; ~ ~ - T^ ~A~f~M~ SwaM subsir~td~~bctorr me thls day ot _ T . . J+3 ~S~O . ~~~j s~ TiR=~• ' ~ , ~ • A.D. l9 7 6 - ~ R9GER P01 TRAS,L C~.ERK OF C IRCUI T COt~T ST. LUGIE COUNTY, FLORIOA • ~ 8Y: ' ~ \ EPU LERK ~~zs1:~~~E s5i ~ ~ ~