HomeMy WebLinkAbout0083 ' ~ ~eclara~~~~ d~ ~~~nicQl~ and C~~~ze~s~ip *
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TO TNE CLERK OF TliE CiRCUIT COURT. , .
_ ST L UC 1 E ~puN'ry. FLpR1DA: '
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This b m~r deela~atba ot Domlctle and Cittsen~hip in the Sbto ot Florida that I ua fitins thi~ d~y tn accoed~nce. ~ed in
tarfortaitr with Scction 2~.~7. Florid~ Statutes.
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I wu tormerl a legat reaideat ot G/'d/~C~ .~/Ll.t~'/~S ~ ,~„Lr' aAd I
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residt~ at s~,L'ZC d
s/J/r'~°. ' _ Nawrevee. I have eMnged ~y domicila to ~
t3ee~l sad N+~mb~r~
and a~m and have been a bona Gde sesidsnt otthe St~te ot Florida siace ~ dp? ot ~
~ 19,~, and I reside at f l/~ ~~-°h
_1 t8teNt and N a~Du1 y
~[.i°~~~1L. 8~ - ~ ST. LUG 1 E Councy. Fior~a..
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' and tA~s statemeat is to be takea u a~r declaestion oi eitisenship. actual legat restdene~ and danieite in the Stato of Fbrids.
~ IF fOR THE PURPOSE Oi ENROLLING If i0R HOMESYEAO PURROSES~
CHtLOREN IN SCHOOI~ PLEASE STATE .PLEASE CHECKt ~
TNEtR NANES:
f LEO AN~ REC ROf 0
f~ ~?ER
~a~R~A= lA.
~ER~ ClRC~ COU11T ~
ItEQORO rE1tIi1E0.....~.~
FE8 I6 Z 20 PN
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I FUATIiER CEItTIFY that I~w~l tegister at my local address when tfie registr:tion books reopen, and wmply rvith all
otMer requi~ements ot a Iegal resident ot this State.
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I FURT1IEIt CE tl~t have no intention to retura to m former domieite. and I inicnd to remaen in
e/l.Sre __~!g~G ~ ~T . 1. UC ! E County,
lCit~) . .
Ftorida. permanenti~. ~
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Swoih ttlYh~sub~scrtbed before me this ~~C- day of
- A.D.19.~ 7 -
RO~ER P01 TF2AS„_,CLERK 0~' C IRCUI T GOU2T .
ST. LUGIE COUNTY, fIORtUA ;
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UTY ICFtK -
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