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HomeMy WebLinkAbout0355 . _ ~ w . ~ _ . . - - < - - _ . _ _ - . _ _ _ . . _ ' Declaration a~ Domic~le and Citizenship . ~ . ~ ~ - '-f ? . ~ ~ ~~6335 ~ ~ - . To~c~co~r~ccRCUrrcovRr. . ~ ..~,ST• 1 UG 1 E.,,,~OOt1N1'Y FLORIDI~ : . ~ . • • TMb M~r dee4ntio~ ot Daaidlt aad Citi~ea~Aip ia tM Stae~ ol F1o:ida tbat I sm t~ tAis dy le ~aooid+u~c~. aad ie , cea~o~ntt~r ~?Itl~ Satioa Z22.1t. Flo~ida ut~s. . I Ma i rl • M;s1 rasideat ot ~ ~ I • . . ~ ~y - ~+r~ld~d at . ~ Ho~rtrer. I ba elu~d aq? doa~ia'N to lSteNt ~d K~ne~N . • aed aat aed bare b~e~s s boa~t Gde t+eaidsat at tAe &at~ ot F7urids siaee dyr oi lt~ sad I resid~ ~t O ~i~- . - . lat~wt Nd 1 . . ST. lUG t E ~ - cav~ _ - " iod tbb state~neat b to be takca as apr dedustioo ot eittaeaship. setual kga! re~idenc~ ~ad do~ata7e in t6e St~te ot F1o~id~t. . If fOR THE PURP~SE ~OF ENROLLiNG ~ IF fOR HOMESTEAD PURPOSESi CHILDREN IN SCH001.~ PtEASE STATE PLEASE CNECK: "THE iR HAMES2- - ~ ~ , . ~ _ , _ . _ . _ ` , J RvStE P r"'- ~~~K CIRCUIt ~R~~ - t~r~~~~ y-Rt~?F0 ~ - . ~ ' ~ - I~uuG 1~f j . _ _ , ss PH tl ~ 3~?'633S I FURTAER CERTIF~ that I wOl register at mp Wcal addns~ ~vhea tLe registratioa books reopen, aad oo~rnQly ~?ith ~tC otber requirements ot s kgal resideat of this State. ' . I FUBTHE~4 CERTIF'Y thst I luve oo L?tentioa to retarn to m~r tarmer doa~. and I intcnd to remaio ia ' St . L v c~ E ~ Cow,c~. ICU~) . . - I~'lorid~. pa~a~aneotl~'. . ~ - _ . ••1 • ~ ' j~ ~ . • ~~t~~~,"~ ~ ~ . ' ,y i 3 y~ ~ ~ ` ~ n ~ - r:' . ~ . , ~ ~ ' ' • . ~ t ~c' >yk • • --~f ~ f.~-! . • ~'C+ • ~ ~ . 1 . ~ `~f~3.~~ ~ . . V= ' ~i~, ~ ' - . . ~r,..s.~ . 3 ~ ~ . w,aa,~,,,, s- Sworn to ~ad sub~cr~bed bolore aie this ~ diyr ot ' , - . _ . A.D.19..Z7 R S C RK OF C IRCUI T COUZT : sT. ~uG i E couNnr, ~~oR ~ dn ~ _ ~ • BYs ~ , EPUttr Rx _ ; - . . . • ~V1/11~~~ ?~Y[ _ afrn r---- -