HomeMy WebLinkAbout0839 Q~~~~~-~t~~n af l~~~~~~I~ ~nd ~:~tiz~nsh~p `
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TO 9'UF: CI,E:ltF OF' TNF CII:CUIT CO[1RT.
_~TSTi LUG I E COUNTY. FGOR1nA:
This is my Jrclaretion of numirile and Citi~cnyhip in the State ot F'lorida thnt 1~m Gling tAi~ dsy in accordanee, and in
con[urmity w•ith Scctiun ~.17. FloriJr Statutes.
I was (orm~rly a 1~•ba1 rrsidcnt ot ~I , and I
~'L tCityl IStatel
residcd~at _ 1)~._t 7 F' v iJ~ l~~~i f(~f~ ,~('Cl .}iowever. I have ehsnged my domicilc /o ;
(Stmt and Num6e~)
•ncf am and hare bcrn a bonu fide residrnt of the State o[ Florids ~ince day ot
_ , _ 19 , aed I reside ~t ,S ~
(Street and NumDer) ~
f
c.,[~ ~ ' f; C~'„
f . ST . l. UC 1 E County, Florids.
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and this statemcnt is to be taken es my Jectaration ot citifrnship, ~;tua! ~egsl residence and domici)e in tht Stute of Florida.
(F FOR .TNE PURPOSE OF ENROLLING IF FOR NOMESTEA~ PURPOSES~
CHIIDREN IN SCHOOL~ PLEASE STAtE PLEASE CHECKI
THE IR fiAMES:
N~v ~ ~ 12 a9 PM ~~a
:1LE0 *NO pECOR0E0 ;
!T. ~08ER
POITRAS ~ `
' C~ERR CIRCIiIT.COUR =
RECOR~ ~?E1tiFiED j
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I Ftil?TlIER CF.RTIFY thnt I will re~ister nt my la al sddress w•hcn the refiistrali~n books reopen. and con~ply witfi ~Il ~
othcr r~~quirc?r~ent~ of a legal resident o[ this State. '
1 FURTHF.~i C4~;~;TIFY thtt T h:~~•c nn intrnti~~n to r~turn to my former dor:tic~le, and I ie~tend to mtnain in
~ ~ . _ T UC 1 E . Coonty.
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~~4C IN~JTII~I F
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C«nrn fo n~d tiuhti~rih~•d heforn nic this day of ~vf l
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. A.l~. 19.7~ . ~
HnGER_f'01_TEtI.S, Ct_f_12~t _OF f. tF~CUI T COtk2T ~
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ST. L!~ 1 E COUIJ7Y, F L Oft 1 UA
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BY: ~
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