HomeMy WebLinkAbout0717 ~~.ct~r~~~~n af ~~mice~~ a~c~ CitE~~•~~t~c~ ~
~f
~ 422612
1'0 TFi~: CI,F:ItK U}' TiIE: C1RCUIT CQURT. ~
_ ST t L UC ( E__ COUNTY. E'LOItInA:
This is n?y dccia~ation o( tlumirilo snd Citizrnship in ihe Stnte of Florida thrt I Am rling this day in accordancc. and in
conformity with Section ~'~.17. Florida Statutes.
I v?•a.v form~r~ s tegal nsid~nt o[ _ MGl C ~..e-~Gl ; 0~,11 d ~nd I ~
1Ci~y1 (Se.t•i
residecl at _ I~~ N~~I C f e;, * ~e. ,1lov?evur. I have ~hangrd my domicilc to
(Street and Num~eri
enci am and havc b~en a bons fide re~idcnt ot the St~te of Florida ainco ~ day oI
) y .19_L.L_..~ and 1 resido at ~ 7~ ~ S. ~~CC'Q Il ~ ~ J '
~1
~glf!!~ ~ riLR1blf`
~'~~iy1 P~ ~ t'C e. ~ ST. ~UG I E County. Flo:ida,
lCit~)
and this stalemrnt is lo be taken as my declnrntion oi citizenship, nctuel Irgal rcsidence and domicile in the Slate of F'lorids.
IF FOR TlIE PURPOSE O~ ENROLLING IF FOR NOMESTEAD PURPOSES~
CHILDRfN IN SCHOOL~ P~EASE STATE PLEASE CHECK:
THE IR NAMES:
NoV ~ !Q 3~ AN'18
t1LE0 AKD ~ECOADEO :
iT.`UC~E COUl1TY.il~. ~ ;
POLER PG~TRAS ~
CLERR CIRCtNT C01111
~EC~O vERiFtEO ~
~~~~i~~~
I FURTEiF:R CERTIFY lhat 1 witl n~Rister at my tcxal addnss K•hen ihe registraiion books tr.vpen, aod comp)y w~ith nll
othcr mquircmrnts of a Icgal residen[ of this Statc. -
I FUItTJIT~;.; ('F:FiTIFY th^t I h1t•~ no intt-ntiun to r~turn ~to. ~m.,~..f~o.r.~m.,cr dnmici!e, and I intend to remain in
J T~ L
U C 1 E . Counly.
IC~tJ! .
Flori~la, pcrmanen~ i, .
~°~~lh!
C~U,yTy
. ~-~~,3 ~C~ f~ ~
~-.Z ^ ~ ~ ' G - %l,t~- ` '~K--~
t '1,
t.~._~.,~ _
` ' ::`-''~,c: _ (:JaMe) , '
u' _ 7U / ~ ~C~~j,~ 1 !!~i .liC1 a1
~C IAddnas)
~worn to,nd suhs, ri!x~J ?x•~ore rttr tF~ts ~ _ dey o! / i.~ ~,t,•( ~U
~ , n.~,. 7 f . ,
R~GE.R P4_I TF~~~S, CLE:42K pF C 1 FtGU t T COI~Z T
,
ST . LUG I E COUNTY, f l_OR 1 UA _
is
~Y: , ~
}
- 3
EPUTY LERK
it
i {
~ . a~~~~ 7~~
~~c~
A(.O E~orm T1 :r•
. . . . . . .'~rixs:~:,:~:-=s~....•.::e'i~tF.~~• .s i-<A~.-r..r~..r..._._....r.sr.....+5..~,a.;~.. ~ _ .