HomeMy WebLinkAbout0286 ~ t.~ ~ ~ ~ ' ~ r ~ t .1 ~ • ~ , ~
~ • ! . r , ~ : j • ~ , • . t,• ~
1 .~r • • s r• r Y r t
l.~......f-_} ~..a~~, .~ali ~}li ~~....rl~~{.~l/N~+~. l..\ `.'~ML.Yl.~~a''i.~t..~~.1/~~ /
~ ~ ' 39-,ap80 ~
9'0 T1lE Cl.l~;tti~ OF' T!1[: C1ftt:U1'C COUlt1'.
S7. L.Ui, l E _COUN'11 ~ FI.O1tIUA:
, . s
Thi~ b wy d~ clacation of I~o~nicitc cnd Citizcnship in thc Stntu of f loridn thet I am fili~q this der ia acc~rdcnce~ and in
eanfarmity wilh Scrtiun :~.17. t'lorids Stetutes.
I was farm~riZ ~ ir~al resident of ' snd I
- - - _ - ---r ° -
IClty) (5 atol
residrd nt ' }iowevct, I h~vc chsngcd my do~~icilc to
(Stt+set and Nun~bcr) ~
and ar:~ a:,d have bLcn n Goaa (idc resident ot thc Stste ot Fioridn ~inco / w~ dry of i
- -'U ,1~_~.Z, end I reside at rl FI t~ ~_~f ~
• " if iStre~t and tiumbet?
1 w S(. L UG ! E COIl(lty .~'~1U(I(38.
(CitJ)
and l~.i~ stnte~ner.t i~ t~ bc taken a.a my declsration of ci;izrr.g~ip. actuai legul re~idenee aad doraicitc in ihr. State of Floridn.
IF FOR 7NC PURPOSE OF E~:ROLL ING If FOR ttOMESTEAn PUkPOSE:S~
CHlLAREt~ (l~ SCHOOL~ PLEAS~ STATE PLCl,SC CNECK: ~
TNEIk NAM£S;
I Ft~t:T~It:R CERTiI'1' t':::t I~~i~l rr~i:i~:; at r.•~ locnl edd-rs~ ~:hen thc :cr~strztion ba~~;s rt~~~cn, and co:iy ~.•it`~ r.!1
ctl:ri rcrjuircr.+~•nts c•i z 1•~F; rr.:~ieut of t'r.is ;^~tc. -
I F rT~i.:~t C::f:Ti~'Y tts; t 1 havc ir,irn:ion to return to .^.:y (or..irr do~aSci!^, and I intc:~d to rcr.:=in ir.
~ ~t._ 1:!%~_~'- ,Cou~ty,
(C~t~) _ ,
}'tor~~~, ptrr~l~ie~iui,,
, "'1./~~=-~-- ~f~~z~.~
~t
C
1 `F i • . ~ ' ~
r_... • r , S ~ ~ ~ / ~ / ~i S _
~v.:' ~ { , -
v: ffrj _o
r ~ _
' ,<'~`°i•}~7 . (::a:
~r~~~ ~ , .`~f 1L._~._/-~S ~_L~~~~C
'~~f
~,~~,~~~;~r • t.. "v ~.1 ~
Sw-c+rt~ !o n~:~!'~^T.~~.
'~.~t~it'•e~! 1~.•tvrc r;~• t`,;s d:.~- _
f••~~• i`'- ~(y 8~
lUC
E COUMTr
~ . r ~t• r- r ROCER POItRAS A.
f~~"~:, f'i1~'rr',, C} _ `_~i 1~_. ~117__( C),•,l ~ Cl.ERK CIRCW~C01J T
S1 1'. 1 L' C.i?:1:~7'!, I~i lt`.~ ` . .~~~=FIEO..,,~,~
• ~AK Zj 3 34 P~'I'~8
' _ r ~ - p _.j
:~,`t ~ ~ _ 3920~80
.
aooK ~81 P~~~ 285