Loading...
HomeMy WebLinkAbout0352 _ ~ . . • • ~ • • . • / 1 Dectarat~on af Dom~c~ie and C~trzensh~p ~ ~ . . . ~ ~ ~~«.~o~~~~~, ~ . . . ~ ST~ ~ E.._. .,OOtJNrY. RiAAml~ . , ~ . • . - . } ~Lb b ay? dedaatbs ot DoaAicib aad Citi~aaship M tM Ststs ol I~'lo~id~ tA~t I aat ~ t~6 dyr ia ~ooordaaos, and ta { ~ontormity w~h seetia? ~28.17~ Flo~aa statp~«. ! I~?1u~ ~ a IKaI t~aWNet ot . C1 nt ~ n u~t ~~1 i f~ a~d I . t . tCIV1 ` ~ 1~i ` ~ tyid~d at ~___r____.. Harswr. I aaw ehan~d reqr doinidk t~o . aud aat at~d ht~w beea a boaa fid~ rasidint oEtbe Stat~ atFlocida siaa y dy o~ ~ lf~.~ and I c~sid~ at . t~tr~c~Mt~twi~i - ' . ST. ItJG ! E ~ ~?U?:1''~~a. ~ . ~ _ tt~qrt _ , . ~ i{Id L~ i~i~QlIItA~ ~ ~O ~~iA ~i 1~ ~Clita~OA OI-CI~OSA~~ ~Iti~ ~ t~O ill~ d0~0 ~11 ulA a~A~O Ot ~OfT~. IF iOR THE PURPOS~ OP ENROL~ING - Ii iOR HOMESTEAD PURPOSESi CM 1 LOREN 1 N. gtH00~.~ P1.E1lSE STATE P~EASE CNECK2 ~ ' rNEtR NAMES:. - . . iT. C01~~ji ~ ~ ~OCER r01fltAs . . • CtE K C~RC~11t COpRT y~R~F1E.0 ~ ~ Auc ~t~! ~ oe pM •~y : . . s~2 _ I FUftTHER CERTIF'Y that I will rcgister at my locaJ addnss whea the ngistration bodcs ttopen, and ootnpir with a1! ot6er requiremeats o[ a legal tesident a~ this State. . -I FU ~ R CE ~F'Yd~G~ilave na inteatioa to retara to ue~?~tormer e,do~eile. a»d I iatend to reawn in e - S . County. t~f1 . . ~ Perma~en~~,; . . ~ . . ~':t . _ ~T C p•ti1 _ t ~ ~~~•~qp4 V ~ . _ . . ~ iti ~R ~ - - . . ~ ~ - J?. y * 1',.> ~~i ~ = _ ` . ,~s:_ ; ~ . _ GO ' f'~~s. ' ~ ~ - : .'1'~ ~ ;`'1~~.- ~ . : V : s~~~ . •.~~~'••e..•••' . - J - . ~ ! ~~j'~ jj~~~s~~ 3~~~~ . . f ~ ~ . ~ . . •''tt~t?~~t!~~~k~ . lNawr fA~dews) &worn-to and suWesibed before me this ~ day ot ' . - . ~ A.D.l9 77 - . R S C~ RK OF G tRCUt T CQU2T sr. ~uc ~ E. cour~nr, f~oR 1 dA ~ . ~ . . 8Y: - ~ ` EPUYY LERK 8~~~ ~ ~ ` • ~ . . . ' _ AGn i`nrru'ft.^»