HomeMy WebLinkAbout2127 Ueciaration ofi C~omiciie and Li~izenshp
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row c~Rx oF~ cntcurr covR~r. 9~i~;Z38
S'~•. LUC 1 E OOUNTY. FL013IDA:
~ This 1s aoT dee]sration oI Da®ia'le and Clti:eaship io the State o1 Florida that I a1a Aires this daj is aooordaaoe, and io
eoafottdtT with Seetioa 2?2.1T. Florida $tatntes.
r I was a kEal resident oI ~~l 1`El'~l 1 ?~M~1~h - _~_~1,'~e
• ~ aad I
~
(At ~ ISwd
resided at ~ ~ ~ ~D ~ I ~ ~ ~ n l.C~ ~ ~ e . - flowerer. I hays ebacSed mT domia7a to
18trad and Nambsl
and sm aad bare been a bona Sde resident of the State of Florida since u ~ ~ ~ ~ daT of
19~ and I reside at a t ~ f.~ S • E S Lt In~?o~er S-}- ~ ~
3
. ~o h'~-' - ~1,~C1 c ST LUG i Esti..c..aN.ae•~ is
• 1~1 ConntT. Florida.
and this statement is to be taken as mT declaration of citisenship. actual legal residence and domiale in the State o[ Florida.
Ii FOR THE PURPOSE OP ENROLLING IF fOR NOMEST_EAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PL'E'XS~''•CHBCK:'
TNEIR NAMES:
brrlie C~lern~tln ~Qn 1 n
• i
~u ~ r~ Gc r ~ i iT In C 1 Y1 C/
1919 AU5 16 P~ I~ 31
SLlE1
CtENCppR~~Ep~TY.FLA.
ROGER POITRA
• ~ ~ t:LERK CIRCWT T
RECORD VERlFlCO
I FIJRTI~R GF.li1'1F'Y that I wtV register at mT local address when the registration books reopen. and comply with all
other requirements aI a kgaJ resident of this S4te.
I
j I F[JATIIER CE~fi1'ff'll that I have no intention to return tom former domiu'le. and I intend to remain in 4
- ~ T U G I E , Count. `
f _ tG"e~l -
Florida. permanend;.
~ S• ~ S ~
laaw) e~ =
1
Sworn to and snbsaibed before me this ~ daT of ~ ~ 1t ~ ~ C / ~ ~ • 33T~
f
R ER CLERK OF CIRCUIT GOURT , :.;:~iii1e'•.,,
ST. LUG 1 E COUNTY, f LOR 1 OA - - :
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