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Home My WebLink About0714 . . ' Deciaration of Domicile and Citizenship . ~ . . ~ . t . . ~ ~~i~~ ;f TOTHE CI.ERK OF THB CUtCU1T COURT. . ST. LUC i E ~pt1NTY. Fi,oRtDl~ ~ , Tbb b aqr daluattoa ot Domkile aad Citisensh[p ia tM State ot Flocid~ t!u?t I am Clia~ tbts dy? ta acoordaaee. and ta ~oatorait~r witA Seetiva 222.17. Flo~ida Statnta. . . I ~ra t meri~ a bgal resideat cI - O~'~'~ "'d I . tpy) ~ 18w~1 ' ~G ~ ~..c_ Q.+w. _x~. ie,?~.~~,a~a a~~ ~ ~+a~a.c t~..`..~N.~ / / 9 7 7 snd up aad bave beea a boaa C~e ses~deat ot tbe Stat~ ot Florida siac~ ' - - - - ~~_..aa t ~ra~.t ~ y3 ~ l~.~.~ ~C.G.-~ • -lBtrMt ~ad N~~osl ~ ~'J` •/~Lt,t,c~ ~ ST. LUG 1 E Cow,t~,~ F1o~d„~ . _ tav~ - " ~ad this st~te~aent ts to bs takea as eay dee4ratioa ot eiUzeeahip. aetua! legal rssideoee aad doaaieile ia ths Stata ot Fbrida. ii POR THE PURPOSE Of ENROLLING ~ IP i0R NONESTEAO PURPOSES~ CHILOREN IN 8CNOOL~ P~EASE STATE PLEASE CHECK: ~ TNEiR NAMESL ~ . ~ - . . C.: ~l~r~.t/ ~ . ~T.l~C1E C~WRY flA. 110CER tOtTRAt ~ • CLERK CIRCUIT COIMT ac~~~p vfAIF1E0~.~.~. . A~ 8 3 sv PM'1T 3'~~6~ i ~ I FtJItTHEB CERTIFY that I w~7t register st mr to¢al addnss w6en tbe ngistntion books reopen. aad eotaplp with all j otber r~qninmeacs of a lega! nsideat of this State. I f I FURT~iE:t CE that~/~?ve ao iateatiou to ntnra to m famer domieik. and I iutend to teiasin in - • A~~ _ (r C,C~t~t.LJ _ ~T . L U C 1 E . Couaty. IAyf . , - Florids. Perms~eoci;. . ~ i}' •4 ~ • ~ ~~'Vr • ~ . i~ 71~~~, '~•~j ~iI S ~ . . _ ~ . j~r I~ ~ ~r~; ,s_ , - i: i ' : `'_4: -,r-. , 4 S ~t.-'+~ •w ~ ~ ~ ' `-:7~Y:~-_ °.=ls .~'~a' . . - - ~-:~.Y~: i~:. . . ~ ~ R'~r > s~ .vj . ~~V~t :~~}t~~~ ~ ' • ~~~i..~~~ ' _ ~4.1:~' ~ • . . . , ~ o~ 7 °c"Yic' . Sxora to and subaerlbed bctore rns thl~ da o[ v 7 . ~ ' - . • ' A.D.19.Z7_, " R A C RK OF C RGUI T COUtT • ~ ST. LUGIE COUNTY, flOR1UA ~ - ~ . • • . ~ , BY: . _ ~ ` ePUttr RK ~ • ~ ~ ~ d~c 2~ PIt6E ' 7~~ L . . _ _ _ ' : , _ ~~~c~s.,3".X~ -`~"~'~a` ~~9~~s °S~ ~"~.,~v _ . ~-'.~~'~.r '