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HomeMy WebLinkAbout0238 ' I~~cE~~-~fi~n D~~iicit~ ~~d Ci~~~~nship TO T~IE CLEItK OF TII~ CIRCUIT COURT. ~ 3~'4~g~ ST. lUC 1 E ~p~y. ~p~oA: . • ~ Thi.+ u mr deelaeaiion ot Domicilo and Citis.enahtp la ths State ot F'torida that I am Ciling thts daUr in ~ecordance. and in ~ eontormitr with Seclion 222.17~ E'lorida Statutes. ~ • . T • ~ • I rva~ tormeri a~egai reside~t o[ - . aad I 3 D gA-~ 1 ~1 tt~tr) ! : te:kled ~t ~ - 3 . Ho~?ever. I have chaagcd my domicile to ~ ' t&tist and Num~) • . and am and have been ~ bona fide re~ident of thc State ot Fiorida aiace ~ , day ot ~ ~.19.ZZ~ and I teside at SI 3 1.~r~". ~ - i l3t»~t ai,d Numbu) F - ¢I ' / ST. LUG I E Coun:y. Floriaa. f l~~ ~ " and this stntement is to ~e taken u my deeiaratiao of citiun~hip. ectual legsl re~idenee and domieik in tfie Stato oi Florida. If POR THE PURPOSE OP ENROLLlNG , ~ IP FOR HONESTEAD PURPOSESi CK I LOREN I N SCHOOL~ PLEASE STIITE PI.EASE CNECK2 ~ ~ TNEIR NAMES: : ~~tP,_~._.~~,13fj "~~Q S ~ - ; 0 ~~'~fa ~s CtERK CtRCU1T COURT . ^'r~~p VEAIf1E0 • ' " Auc 2 3z PN'1T . . ~ ~ ~ ~ ~ 3'7~~.9~ _ i . ~ f 1 FURT~IER CERTfFY that I w~I register at my local addres~ when the reg;stration books reopen. and co~nply with all ~ other requiremcnts ot a tegal resideat of this State. ~ £ ~ . z I FURT E~ C R1'IFY thst I lisve tcntion reiurn to my [ormer domic:le, And I intcnd to remsin in ' ~ ~/~~D_ A~~,~ ST. LUCIE l(St~) _ . County. Florida. permLnenti~ . . . ' , . i C n •j,.,, .ii, v , . , . ~ _ ~~-Sy - - • ~ = . ~ . ~ _ . , A : . ~ : _ ~ ; . .~:t~~~ ~ ~ _ . • - •'~~.~~~~f~~~ ~ . . f t.~ , G e ~~C`~L~ ~C,d c. L~'. • , ~ . _ .t~.~~~...... ~ ~7~ ~'1. 31~~ ` ~ (Addreu) SNOrn to and subscribcd bo(orc mo thu --"y~ dar of ~ € , A.D. l9 77 _ { ~GER PUi TRAS, CLERK OF C lRCU! 7 COlx2T ~ ST. LlJG ! E CQUNTY, f lOR 1 UA • $ . • ~ . - . ~ BY: ~ ~ ; EPU LERK ~ ~ ~ ; ' ~~.~~ur~~~~. ; _ - - - ~ -.L - - - -