HomeMy WebLinkAbout0970 . ~
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Decara~E~~~i _Q~_ D~oc~cile and.. Cir~zensfip - _ J
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S~. LUG 1 E apj~TY, FLORIDA: .
~2~'1~ k s~ dee>aratioo d I)omid4 dad Qtissaa>fip ie tbs Stets d Florida that I am ~i tbis dp is aooordanoa. iud L
. _ oodorm~ wilt Ssetioa x.17. llorida Statutes.
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I was Pone a kcal re:ident d ~~_~...L~r~_ - - L %~2~(~ and I
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resid.d at / ~/.,l F i-,~r Iy -Howeer.I>mna cLaaj.d m7 do`nie~e tp
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. end am and tiave bes®a bona Sts:eside~at d the Stated Florida ainoe /-3 'ry"' ds,I d _
~`?a I .191~`L., aadlreaideat 9 ~ ~S~ s s f~~ ~
ST. LUG I Eea..e,.a>v.~•~l fib, ~;d,, .
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and this statement is to be ta><ea as mT decLratioa d eiti:emhip. actual keel residenos and domidk is the Stall d Flarida.
IF fOR THE PURPOSE Of ENROLLING If fOR HOMESTEAD PURPOSES
CNIt.OREN IN SCNOOLa- PLEASE STATE- PLEASE CHECKS
THEIR NAMES:
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_ 19T9 AUG 28 AM ~ 25
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STROGER~
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CLERK gRdMT T
RECORD VERIFIfA
456448
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I Fi1ATIIEB C~'Y tbst I wi8 registry at aq local address whey the registrstioa boobs reopen. snd compl7 with aD
atbes regmeameats d a kcal. resident d this State. _ _ _ _ _
I F'[iR'1'~ GQt1'II''Y that I have no intention to return to m7 former domio'!e. and I intend to remain in
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Florida. per~°'',;
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ST. 11161E COt1NTY, 7 '
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EPUTY LERK ~ '
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