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HomeMy WebLinkAbout0069 ' C~eci~ratian ~f Do~nicile a~~d Ci~tizenship . . ~ ~ . . : , ~t ' . . . . . . . . . . _ . f L ~ ' . ' ~ . . ~ . . i To~ue c~K oF~ cu~currcou~r. . ~ ~ . ~ . ; . ~ _,,,ST. LUG 1 E ~pUt~'1'Y. Fi.ORtDAs ~ 2 . ~ ~ TbI~ u my deelaration ot Domicile ard C~tizenshtp in the Stats ot Fbrida that I am C~lina ibis diq? in ~ceord~nee. ~nd t~? ~ j ~e coaformity with Seetion 222.17. I~'lorida Sti?tutes. . , ~ {a I rrss fotn+erl • legal res~dent ot ~~D~ ~uC? ~ -~w~ and I~ . . ~ tesided at ~~4 m - H~,?~.I6a~e cban~ed aUr docnie~e to ~ , (8ttwt and Nom0~t1 ' ~ ~ and and h~ve beea a bon~ C~de e~sident of tAe State ot Ftorida stnc~ ~ d+U? ~ - . , 19~. and I resWe at ~°"T`'"~`J ~ ~Nam~l ' ~r• ~+u~ ~ ST~i LUG1:E Councy,Fbrida. - . - ' ~ t~nd thb statement is to be talcen w n~r dedaradon ot elUseu~hIp, adual kgd restdee~ce aad domicile ia tbe 3tato of Florida. If iOR THE PURPOSE dP ENROLLING. IF FOR HOMESTEAC PURPOSES~ ~ CHI~DREN IN SCNOOI~ PLEASE STATE PL'EASE CHECKt ~ tHE1R NAMES: ~ ~ - - . ~-p - ~ • ~ ~ ~A. ! ~ ~ . CCER~ • f . ~ ocr.~R~ VER1i1 p~~~ ~ . . , : - . ~ SfP 9 ~ ~ 13~'{ ~~1 ; , . , • •4 ~ - - t • i • . - ; . ~ ' f i _ i . . ~ s I FLTATNER CERTIFY tlut I w~l register at nir loeal address when the registratioa baok~ nopen. •nd oomptr .vich all ~ othrx requisements ot s kgal resident o[ this State. - - ~ t I FURTHEZ CERTIFY thst I hsve ao I~trntion to return to m former domiu~e. and I iotead to remain in ( ~ ~T . L ut 1 E _ Cwmty, ~ l(~~1 . _ . ~s F{orida. Permaaeot~•. ~ . ~ ~ ~ ' . t.,: c . ; : ~ , . . ; . , . : U : y~~, - .i .f ~ ; ' o i % ~ • ~ „s_: _ G ; ~ Fl . ~z ~ . . : C,~J {-t _ . ` ~ , . . , , t 3 ~;r' ~ ? l S ~ D _ ' ! : N e.•' .,:~ti sMA , : ,C,~ C4 . . . ; . . x ' . ~ ` ~T' ~r~loff • - ~ b ~ tA3•~~t ~ ~ Sworn to a subxribed beforo mo th~i dsr o[ ~~~u E 'd 3~' ~ . . A.D.19_~~_, " ~tOGER POJ TRAS, GLERK OF' C IRCUI T_ COU2T ST. LIJG 1 E COUNTY, ~ f I.OR t UA - • ~ ~ BY: ~ - ~ f e PuT Y c.F . . ~ • . ~ ~ : - - ' dWlf~~ P~iE .W AGOP~rn?!-?2 . . _ _ , . .-,:..~.-~a.wr:......y- ' ~