HomeMy WebLinkAbout0766 ~ x4:.
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Declarat~on of Dom~c~le and Citizenship . .
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TO THE t~.ER1C OF THE CIIiCUIT OOUliT. .
ST. lUC 1 E pp~y. gj,p~pA;
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11~t b ap d~etaratioo a[ Damidl~ and (~tts~aship is tb~ Stat~ d Floeida t6at I am SW~ t~ dq i~ aoooe~daoa. aud !a '
oonionoit~ witti S~dioa ~.1T, Ffoc~da Statut~s. .
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I was f
rn~ a Issal ra~ideat ai *.fr-u~ p s: ~ r t i p:? • ~ and i f
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~„f, 2203 l:efil oc ~ Dr . - Hdww~r. I Lsw ehsn~d m~ domi~3ie to
I~Mt ad N~M~ • - '
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aod am and han beso a booa Sde reaident attb~ 84t~ dl~7odda siooe , 1 s t da~ d
July ~1~68 ~~I~a lT4 Lucero Drive _ t
t~wt oa N~D~
Pnrt Cfi ~ T.»r_i P ~ ~JT• ~ E (~r0{fIIL~. i
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and tbis statemeat b to bs taken as ~ dselaratioa at dtisenabip. aetwl kaal reddenos aad domieile in tbe 8tat~ d F'Socida. `
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IF POR THE PURPOSE Oi ENROL~IMG ~ " If
FOR HOMESTEAO PURPOSES~ ~
CHIIDREN IN SCHOOL~ P~EASE STATE PLEASE CHECK:
THEIR NAMESL
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~ I F~JATJ~i CEATTFY tlut I wn~i ngis~r at m~ 1oea1 address when t1k ragistration books rsopen, aad oo~ with all ~
; oth~r req~~a d a jegal rssideut at tbis SW~e. ~
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~ I FvRTHEA CERTII~'Y thst 1 have no fntention to return to former domie~e. and I intend to remain in
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~ Fbrida. perman~nd; . . ~
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~ Swa~a to and snbsv~'bed befare me this da~ oi
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~ R A K OF' C RCUI T GOU2T , !
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~ ST. LUG 1 E GOUNIY, f LOR t OA - ' :
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P UT Y K . " . ' ~a, . ~ I
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.~~ooK ~12 ~ P~~E ?64~ :
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RGO Fnrm 71 22 '
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