HomeMy WebLinkAbout0358 C~ecia~afior~ c~f Dor~icile ~nd Citiz~nshi~
~ a;~zz~
TO T!!F ~l.EttK OF'PHE CIRCUIT CUURT.
ST. LUC I E COUNTY. FIARIQA:
This is my deet~r~tion o[ I3omieito a~d Citiunship in ihe Stata dt Flurid~? th~t I am CUng thi.~ day in accordanca. snd in
conto~mity with Scction 2'L~.17. Florida Statutas.
I waa torm~rl s kgal resident ot ~ l'l
f_,~~'[' S~' , ~Q' • ~ and I
ICit~l (Statd
resided at , f~~ ~ 2'~+ ~ . Nowever. I have ehaaged my domicile to
~s~c.,~a cv~e.r~
aed am and have bee~ a bona Cde resident of the State ot Florida since , ~ dq? ot ~
~bz/' .19~~. and I re~ide at ! ~1 / 5 5 0 , ~ 3 =s-` ~J ~
~ (3teret wd hua~ber)
~ ~ ST . L UG i E Couney, Florid~. -
lCit~) -
and this statement u to be takea u my dectaration ot eitizen9hip. actual legAl rr.~idente and domicite in the Stt~to of Florida.
IF FOR THE PURPOSE OF ENROLIING IF FOR HOMESTEAD PURPOSES~
CHIIDREN IN SCHOOL~ PIEASE STATE PLEASE CHECK: ~
TNEIR NANESS -
ivl E S ~ r c{ l" i" c:r ~1 L. % 5
,
>
c i) ii, f
cr ~C~.,G~d r i ~!r u~1 L/ S
. FtLEO AN~ RECORDEO~_,
ST. ~UC1E C^UNT~ : F~IA: .
~
~""4~`~~2`7
'.78 NOV 17 AM 1 i'~Z
c= ~ rr~ ~f• _
CLERK Cf~i.tit' ~OURZ
I F URT}TF:R CFRTIFY lhat I will re~ister at my local address when the registration books reopen. and comply with aU
other requirements of a legal resident ot this State.
I FIfRT~iF~t CEItTIFY that 1 have no intrntion to rrturn to my tormer domi~ile, and I intend to remain in
r . 5 T. L U C 1 E , County.
lCit~) _
Florida, pcrmanenti;. -
. r
~
~G~VfiT$ ro~~.~ .
Z . r i='.O r'-~~ ~ .
yo;:,~~ ? .
J : ~ . • .
~ /~~a~`~.•S~ n -Ll " ~L Q~ Gt~
INune) ~ /9 yC `-S
(Addjes~) ,,L ' /
Sv?•orn ta and Rl1I?SCf1~1rd bctore me thi~ /T/. - day of 1~7 -d ~~i 3==- r,~ ~j
~
- ~~~1!~l'L . A.b. !9. 7 O • '
~ Y
~ ROGEft P017RAS, CLERK OF C IRCUI T COl~2T t~-
~
_ ST . L UC I E COUNTY, F IOFt 1[~A
. , ~
9Y: -
PUT Y LER ` ' ~
• 60L!~~~ rACE ~ , ' -
.
i_
AGO f'urm 71 ;
~
, -
~ ~ - . ~ -
_
-..~s..:_:,_. "~'-~_'~.,'..Y•._~.-_.Y.}.:r.:k~=~;:. ~~e..i="`~~"'-~.3r.:fc.,a-
rm ~ 7 -
.~~'r - ~.~5:~ ;
i~, ~ _ _ . . ~~~~g :~..r
.r~~ . ~.'.~~~6~ ' - I ~ i
_ . _ _ ._~e= ~.s .i..~?! _