HomeMy WebLinkAbout0770 ~~~;f arat~on o~ Dorn~cil~ anc~ ~ ~~~~zensfiip
~ 45s34S
X10 THE t~.ERK OF THE CDtCUIT WUAT.
LUG I E OOUNTY. FLORIDA: .
. f'
,'!'his is ~ dseLratioa ai Domieiie sad ~enship is the Stab of Flofida that I ua ~ this dq is acoofdanoe. and i~
. _ ooatermit,T wits Section ~1.1T. >i7orida Statntas. t
.r I was ~ a legal resident e[ ~ /r ~/1• _ /w/ASS sad I
resided st 2 l5 ~ 1~~f' i J P t ' -Howeat. I luw ebao,Eed aqF domie~. t~
tstrMl asi I~loe.d
_ snd am and Dave bean abona Sds resident of tbeStab of Florida since -T ~ ~ - d~ d
~_t,~. ` LSD ,5.~ ~.~a~?~ .C.~r,rJ
1! and I reside st
~ ~ ST. LUG 1 Esa~a.a>~..ti.~i .
tc~
and this statement b b be taken as m,F declaration of e3tisenship, actual legal :esidenos and damidle b the Stab a[ >;7osida.
IF FOR THE PURPOSE OF ENROLLING IF FOR MOMESTEAO PURPOSES,
CHILDREN IN SCHOOL~~PLEASE STATE PLEASE tHEtK:
THEIR NAMESS
P
I F[JAT~R (~RTII'Y that I w~71 register at mT loin address when the registration boobs reopen. and oomph with all
other segniremeab d a legal resided of this State.
I F[JAT~ CERTIFY that I have no intention to return to former domicile. and I intend to semaia is
_ T. t1 t 1 E J Cooatj.
.
X19 AU6 27 IUt f~ 47 ~~~~T -
- . ~ Eo ~ i~• j~ A. ~A ~
• W 1 tL.i ~M C,~~t ~cRT
_ G.EAK T T
- !Et`ARD VERif1E0
_ - ? ~ ~
45?6345
,p 1
swoea to,ma subs~•bea beioQe me this a T aaT at T e~~~ L ~ l n~,1QL
• K CIRCUIT COURT ` k-- ~
O,; . o ,t
ST. LUG I E COUNTY, I: LOR 1 QA ~ . ~ ' ~ • ,~-~`/'~-its f ~ ~~;`y
~ PUTY LERK •~i'+~~~
BOOT( -
` PAGE ' I VO , ~ '~~i`~~~'~g~ •'r,