HomeMy WebLinkAbout0984 . u~c~arat~an o7 uo~rnec~~~ ai» V~~~z~nsr~~p
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TO T1IE CGERK OF TitE CIRCUIT COUitT,
SY. LUC 1 E ~ i
_ COUNT'Y. FLORIDA:
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7bb b iny dselaration o~ Domieile aed Cit~eeahip in the Stat~ ot Fbrida that I aea fi4n~ this day tn ~cco~d~na, and in
eonlormity with Settion 2~.17, Florida Slatutts. +
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I ~ras ta~me~l a ksal t~aident ot t z E 2 ,~Dy T f? 1 ~,u_H and I .
tC1t71 lstat~)
reslded at ~ a X - Ho*?ever. I Aav~ ehanged my domicile to ~
11en+t ~nd NuoD~t) • ~
and am aad have b~ep a boaa fide re~ident o~ tA~ State o[ Florida aine~ q~ day ot
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L . l9.,~.. sad I reatde at ,~~~1 u 2C' ~n v n v ~v ~
ISt~t ~ad N~mDa~l
.~jE~i ~ T- ~ U~ i F ~ ST. lUC t E Couaty. Florida,
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and ttds statemeat is to bo taken a~ any dectaratioa ot eitizenahip. actua! kgd residence and domicile iu the Stato ot Florida. _
If POR THE PURPOSE OP ENROl.LING 1F POR HONESTEAO PURPOSES~
CNILOREN tN SCHOOt~ PlEl1SE STATE PLEASE CHECK: ~
THEIR NAMES: ~ /
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Ct RaCr~CU~{T~s
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APR 53 AH ~~g
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I FURTHER CEftTIFY that I wi]! register at my local addres"s when the rcgistration books reopen. and eomply with all _
other tcquiremcat~ ot a lega) resident of lhis Stata ~ '
I~T}iE;t CERTIFY thst I hsve no intrntion to return to my tormer domicile. and I intcnd to remain in
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Fiorida. permanenti~ .
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Svrorn to ~nd subscrit,cd bc(oro mo thi~ ~ day o[ ' o t_' i ~ j- ~U~ r i~
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. A.D.19!~~
F20G~R F'01 TR/1S,_ C!_ERK OF C lRCUI T COUf2T
ST. LUGIE COUNTY, FLORIUA • ~ '
a,?: 972 ~
c r u t Y ~ c R x . 50oK 2~5 PALt
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