HomeMy WebLinkAbout0231 Declaration of Dorriicile and .Citizenship ~
y
~~o
TO T'HE CLERK OF THE CIRCUIT OOURT. `
ST. LUG i E ~pU~. ~,p~p~:
7'Ab b usy d.el.racbn ot DomiciN aud Cicissasbip ta eM 8wR at Floeida c6sc i.w 61is~ tMs dp ia ioooe~d~..a. a~ h ~
eoafonnity writ6 S~etioa 22Z.17. ~'btida Stat~tes.
1 ~ras t~ a M=al r~~nt ot ~M ~/f Td ~J~ _ , a~d I ~
nsided at ~d 1 I~~Y ~ . Ao+~a+r~. I~wt doiaia'1~ to
~ A1?
Ishwt ~d N~1
u?d ua aad Aave beeu ~ boat tid~ e~aid~nt ott1M 3tat.a otFlorida sina ~ aqr a~
~0 ~ .19_. b_. aad I r~sid~ at 7 a ,,,~3 LLL~ ~h O'NT ~ -
~'T: P, ~r~c r^
L- , ST. LUG 1 E
and tl~b statemeat ~S to b~ latea as ap daclaratioa o[ eitt~eaship. aetwl k~af e+eaideoe~ sod domic~ ia ti~ Stat~ o~ Floeida. i
~
$
If iOR THE PURPOSE OP ENROLLING IP tOR NOMESTEAO PUR~OSES~
CHIIOREN IN 3CH00~~ 'IEASE STATE ~LEASE CHECK: ~ ~
TMEIR NAMES:
s
t
~
~
c~rrr F« '
ROZE~ MA1AS ;
- RECOIW tlERjF~ ~~T ~
:
MaR ! I 2 ~9 PN'1~ ;
. 3
3
aN7~7a~0 #
~
4f
f
j
i
_
i F'[1EtTHER CERTIFY thsc I w~71 ngistec at mr loal adde+eas wben the ~+eaistntion boaks reopes. and aompl~ witb al!
other requirements of a kgal resideat ot this Stata.
~
I FURTHE~ CERTIFY that I hsve no iatentioa to ntnrn to m~ toea~er do~oia~7e. and I iatead to rcmain in ~
' _ ST. LUCIE ~
lCit~) . '
Florida. permsnenti~ . <
- s
~
~
,,,t.....;.~,,,:i ~(s e~. A R o ~/~~1D/i lNA/e
~ ~ ~ ' * • ` )
uw..~
. . { i, ;
: - _ ;
;'~,A " , . • . . e ' U1Aar..d ;
swo ' ~ad wbxtibed be~s~ie thi~ ~ day ot
. :
''~t ~ . A.D.1917 -
. ,r ~ ~
ROGER•`.,QI~~AS~y 's~RK OF CIRCUIT GOU2T
~T'~ '~A ~ '
ST. LUC I E~CO~NTY, f L.OR 1.UA z
BYs
TY LERK
~ r~ ~Q
. ~.s ~ ~ ~(.~s7
e:~
~
AGA Fon~ T1 ~