HomeMy WebLinkAbout0744 t
~ /
~ ~ ~c,~~~~6~ ~@~~~~~~~r~*
k~~~.~~~~ ~t~~~ _ ~ I:
.43~.9~5
j
_ ~
~
~ ,
TO T1 i 1~. CLh:RK OF' TIIE CIRCUIT COU1tT. . ~
, j
r
ST. LUC I E COUNTY, F1AlZIDA: i
This is my decl~ration ot nomicilc nnd Citizenship in the Stete of Florida Lhat 1 am fding this day in nccordancc. und in ~
conforinity with Scctiun ~2.17. Florids St~tutes. f
~YO.AC~ ~ J~Q . nndI ~
I was torm~rlY ~cgal resident oi ~ ue~ '
~c~ty~ ~
resided at 3 9 ~ . Nowever. I hav~ changed my domicile to i
(Street ~nd Numbed . ' ~
nd
and am and hAVe beeA n b~na fide resident of thc StAte of Florida aince 3 O- ' day of ;
; ~ ~ ~
/ ~ ~
~,~.t ~ s-~~ 1 .19~. and I resido at ~ ~ ~
(3treet wd Num 1 ~
~ d. p ~ ST . L UC I E Councy. Florida, ~
i
~at,~
nnd this slatement is to be taken as my decinration ot citizen~hip. actual legal residence aad domicile in lhe Siale of Florida.
IF FOR THE PURPOSE OF ENROLLING IF fOR HOHESTEAO PURPOSES~ ,
CHII~REN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~ ~
THEIR NANES:
~ ~ r. ~A~~ ~FCOROED,- ~
r ~~r_0 „VN~`! FLA•
_ ~i: - ~
431995 ,
~
- - ,19 ~ r;~! 2 6 ~t~ ; ~ 3 ~ ~
~ ~
_ J • . ~ • ' ~ J ~ _
V ~ S
S
~
• ~
iI t
I FURTIIER CERTIFY that I will register at my lceal address when the registralion books reopen. tnd comply witfi all ;
~ other requirements ot a icgal resident of this State. ~
3
~ I Ft}RTHE;t CF.RTIFY that I have no intrntion to return to m~ farmer domi_ ile, snd I intend to remxin in i
- U C I E . County. ;
7l . , ~
~ Florida. {?ermanemi;. ~
~ ~ i
. ~
_ _
~ ~
_;~„~t~~tii~,,,,~ ~ ~1J ~
l ~ . fl L•' fi ;
, , r _ ,
, ,
; sa~. . r ~ . .
'J ~ * ~ ~ / '
~ - ~ ~~~t . ~
iE'c w - : " ? -
~
r : 1r ~ . ' ~ ,
. :~.~sY - : ~ 6~ ~
~ ~ C1Z
~ J't' • . ~ G•~~~` J'~ . ~iC.~h ~Name)
~ • . C t ~ (Addrrs~)
Y ~ ,,•;t~••,
~
Sworn to nnd subscribrd before me this _s~~~ day a[
~ _ -
~ - . A.D. l9_
~ ,
; " .
~ , GER P01 TRA. CLERK OF C IRCUi T COURT ~
~ ST. IE GOUNTY, FLORtUA ~
~ • ~
~ BY: l~
~ Ef'UTY LERK
~ goo~3U2 =~~E 744
.
~ ~ ~
~r _ _ - - - - ~
~ n. , ~ _ _ ~ . . _ ~ z ~
-