HomeMy WebLinkAbout1024 tc
w • a
~~~~~~~~~~.~~e c~~ ~~~~~~~Ec:: ~ ;
. . ~ _
'1'0 TIiE CI.P:ItK 01~ '1'll~ Cl[zGUIT COURT~
ST. Ll1C I E COUNTY. F'LORIDA: ,
This i~ my declaratio~ of namicile and Citizenship in the State ot Florida tt~at 1 am tiling this day in nccordaneo. and in
conformily with Section 22'.17. Florida Statutes.
I wu tormcrl ~ a legal resident ot ~ v~~~ ~ and I
. (G1t7) lState)
resided at n~~ f~~ .}iowever, I haive changed my donucile to
(Streat and A2umDerl
and am and havc becA a bo~ Cdo reside~t ot lhe St~?te of FloridA since ~-~y , day of
~ .19.~. and I resido at ~ ~ 0 k ~r ~"~"C/~
~ (Streat and NumDer)
f-?' J~ z E f iL ~c' ~..D/!- . ST . L UG I E County. Floridi+,
lcacrl ~ - .
and this statemenl, is to bo taken as my declaration .o! citizenship. uctual lega) rc:sidence and domicile ia the Statc oi Florida.
IF FOR THE PURPOSE Of ENRO~LING ~ IF FOR HOHESTEAD PURPO~SES -
CkILDREN IN SCHOGL~ PLEASE STA~E PI.EASE CHECKS r-~,/ ~
THEIR 1tANES: 1
.
T~4m~~tsl ~~1~~rdA.? _ :.~j~; . _COi2~EC ~
. . . . . . .
. ~ ~ -
~a w,v ,~'1 5~~~, - 9~s~
'79 z 9 PEi i: 2 5
. - .
~
- r: ~ - ; _ - - .
I FURTHER CF.RTIFY that I will register st my local address when the r~gistration books reopen. and comply wilh all
~ othcr requirements oi a legal resident of this Statc.
I J
! I FURTHF,R CF.RTIF~' thzt I ha~c no intention to mturn to m formcr do~r?icile, and I iatend I.o rcmain inr
s--- T. UC 1 E . County.
~
(Cit~l .
Florida, pr.rmanenti;.
~ ,~~~r~r;~ " - .
~'n ls ~ti~~i~ • -
` r~
• 1 ~J ~r~ _ .
, , ~ ~ , t .
~ S tt_ z ~ ~ .
~
_ • ~ : A . L
- _ . - • . P~
,LT ~7 / 7 / i / ! ~ l~-
- ' . - -iL R L~ %L lL
_ _ (Name)
~ ~ = ` ~ i, a o x ~ ~.s- S~ ~C~ ci~ ,8/.ri~
~ (~aa,«.i
~ ~~rorn to and subs~rihed br(ore mc tfii4 ~.L.-_ day uf .,.F~.CT ~I C
t~{~,~ ~ . B/ ~A
~ ~
~ - - -
~ ~ A.~~. ~9_ 79 ~ ,
~
~ ROGER PO I TRAS,~CLERK Or C 1 RC U 1 T COUR 1' .
~ ' ~
ST. LlK I E COUNTY, F i_OR 1.UA ~ -
BY: ~ ~
~ - cPUTY ~ef:K . L P ' ~0~~
~ - ~300K r'A~ '
,
. .
_
. - - -
Q~- Q ~."V` '
d~ ~Y?."?^` -
_ _ - _ .