HomeMy WebLinkAbout0109 ~~;~~~~~~~~a~~ ~y~L~~~~~~~; ~rt~ ~~~~~c.~~: ~~~p y
~ 4;z9'7'73
7'U TIIM: CL1:ItK UF 'fllE CIR(:UIT CUUItT~
ST . L UC I C _ GOiINTY, ~•[.o~~in
This ii my declar~tion oi Uon~icilu and Cit'v.enship iu tho Slate ot F'loridn thel 1 nm Cling this dsy in acrnrdsnce. and in
contormily with Section ~12.17. Flarida Stetutes.
, t~l /~/N9n«,~~ c ~ ~.r~ nndI
I wns form~rlv a I~bal resident of (St~ts)
IGity!
residcd et ~ z"~~- 'b ~ . However. l have changed my domicile to
tStreet ~nd NumDor)
and am nnd h~ve Lc~n a bonn tide residcnt of the Stnte oi Florida since ^ ~ day o!
~~j n,,o .19_f h._~ und I reside at ~~.~!<<'- `S-~ ~~N~t c~i ~ S C~ _
(Stra~et and tiumber) _
1 ~o ~_,3~ ~ ST . L UC 1 E _ Co~nt~ , Florida,
cat,t
and this stutemcnl is to t,o tnken as my declaratior. af citiunship, nctual lcgal tesidence aud ~or.iicile in the Stale of Florida.
~ I F FOR TliE PUP.POSE OF ENR4LL (NG I F FOR HOMESTEAD PURPQSES~
•CHILUREN IH SCHOOI~ PIE~SE STATE PLE/:SE CHECK:
TNE IR NI~MES:
c-~~~ :.i:~~ RECORC~D
- _ _ ~ Us:TY. FL.'..
_ 4~q~3
'79 5 AM : 0 9
~
.
~4 ~,.f: - .t~
~ _
i
I
~ I FU1tT11'~:R CI:RTIF~' ~haL i~:•iU r~>~;istcr at my lo:al address ~•nc~n thc rcgislraLion ba::~ rea~en. and co~ply with rll
~ other rc•quirement~ of ~ tc~al resident ot tt~is State.
= I Fl)IZTIIE;t CI:KTII•'Y tha4 I F.:vc no intc•n:ir:n to rntu:n to my forrr.cr ~'omi~:?e, snd I i?itend to rem~in iie
~ ~ - ~~~7~~
. ~U C I F _ , Couuty-
~ lCitY) .
~ Florida, pcrm~nrtu:;. . ~
~ ~
~ . ;
~ . . .
?
~
~ - •~n. y
~ ~ ~ - ' ~ ~ ~ ~ ~ /J/~L E.~~
~ : ..4==.-=:~:~,~ . ~
° ~c: ~
'r_', y ~ ~
~ ~ • c: ~ • . ~ ? •
~ ~~4~~~.,..a' . ~ ~
~ ~ - ` l ~ ~ _
~ ~ <<~. :
~ ~'R=~•:ti~;t.,.;...;
~ `
~ t/~ ~ - !
.'y ~d csa)
~ 4«•~,: n to an:l ~:u~~•.cri!~~ ~i ht~lore ~7i.~ tl~i~ - <~:~y ~
~
~ _ . • A.D. 19.~~
- -
= r~;jc.E.~-r'~'i:~~:n ~,--_~_~~:ti< ~~?=_r._?_?:c~~~-r c~t~z~~ -
~ sz~. couNrY, r~.c~~:~.r:;,
~ r.,r : ~ '
~r~
, -
~ ( ~~U7Y ,f FF:i' ~ .
~ S~C!( ~O~ P%~~E ~OV
~ ~
~ ' s
, n t . , 7 ? '
4"i ~
~a
~ _ • - - - ~;s ~ ~
~.~a f~~r%~r9.v~*' ~s?'~`'4 ~ c
' _ . !""'"~.N'a-. "'?S ~ _
~`u'F`~-ri.
~...,t.. . ,.,<.:~A~`-,w, ~''1 . . -~-r'_.,-a~-...'. ~
_ . ~.w-~_=' _ _