HomeMy WebLinkAbout0161 uec~ara~~vn v~ vv~~~~~~~~ a~~~• ~~~~"~•~..~r T
. 43..~519
TO TNE CLEItK OF THE CIRCUIT COUAT.
ST. Lt~C 1 E apuKrY. ~'[~ORm~:
Tht~ d ay? deelarat~oa or porokils ,?nd Citiseaabip ia tM sate ot FlorWa tlwt I ao~ til~ tAis da~r ia aoootd.nos. and ia
eoufamit~r wtth SeeUoa 22t.17. Florida Statutea.
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r~ a ks~t.rssideat ot p
ICIq?1 L ~~~vo i~~ and 1
~ tt i 7 5~ LA1K/ /L L i w: ~a / S - I~OM~1ilr. I IIiY! ~lfifl~ LO
~ • 18te+~t aaa N~1
aad aaa ~nd bavs baen a boa~ ijde resident ot the 8tat~s ot Fbrida ~iaes
; r~~~ -1~~_+ illd T t'OS~ ~t D~ d P L r?o AU
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FT. r~c c-i -
l&rwt Md N~MrI
} ST. LUG i E Couat~. Flocids,
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and lhb stateanent is b bs taken as mq deeluation ot eitisanship. aetud bsal residena and domieile in tlis 34te d f'lorids.
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IF,POR THE PURPOSE OF ENROILINQ IF fOR HOMESTEAO PURPOSES~
CHILDREN IN SCHOOL~ PLEASE STATE PLEASE CHECK2. ~
THEIR NAMES!
' - FILEO AND~~RECOR~~~.,.
- ~T. l.UC4E COUNTY: ~l.A:
- :-~_COi~D Vc~IFtED
43..~519
~9 EEB 9 PM ~2 ' 09
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CL~F~K CIRCU!T ::OURT
1 FUR1`HER CEItTIF7~ that I w~! regitter at w~ iocal addreu aben the registcation boots reopen. and eomPb ~?ith all
other requlrements o[ a kgal resideat of t6is St~te. ~
I I FUATHER CERTIF'Y that I have no tatention to return to m iormer domicile. ud I intend to reroain in
f : - ~ . - ~ u c r E . Couat~.
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Florida. Permaneml; .
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~ Sv~ orn to and subscr'bed beforo me thia day ot ~~~U 3 bP t~o.J A tl ~ FT. p rk~ FL~ . E
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RQGER P01 TRAS,~ CLERK OF C IRCUI T COl~2T
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ST. LUCIE COUNTY, f~OR1UA • _ ;
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EPUTY. ~ERK .
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