HomeMy WebLinkAbout2669 - s~•
- _ - . 1, t V 1 i V l i,1 U l l 1 l Lr 1 ? L.i (,,f
`1 'i 4t i t I J ~ t i tJ -
4S7435
~iop THE Q•ERR OF THE CIItCITIT COURT. .
S'i,. LUG t E ooUNi'Y. ~~pRIDA» • .
• a ~ ~p ~ the btsl~e oI I'b~ ~ I sm ~i ~ i°~'°'°m~aaae~ and it
contarmit,T with 1T. ~'be~da Statutes-
• i ~ ~ i1l aadI
~ e o o
• aI w~ i
~ • ~ Dt r lCSe~l Havener. I haw changed s41 dpjpp1°~e t'°
residue 3dc-)v ~Nt1Ii'/JlJ~~ ~F~
~ Os - ~ ~t 0~
:Z
ix i±i ~ ~ - Y
a bona Sde resident of the State aI P'brida since - ~ Plg ~
~ am aadbave been
&
~ 191-» a=?d I reside at t~,.,~.,d
ST . LUG t E Coant7. Florida.
a ~ e/~
t~ residence and domi~ in the State at ~7orida-
dec]uation as dtizensluP• adual 3ega1
~ this N,atemeat is to be taten as m;/ -
• IF fOR HOMESTEAD PURPOSES
If fOR THE PURPOSE OF ENROLLING p~EASE CHECK:
CHILDREN IN SCHOOL~-PIEASE STATE
THEIR NAMES:
- ~/9/? ~
t
ti
t• _
twn boobs reopen. ~d comp3p aD
'(;F;g'1'lT'Y thst I w~7! register ~ mT load address when the seg~*a .
~ I resident aI ibis State.
other regaice~eats ai a legal in
domic9e. and I i~d tO ~
tT~
I F[JAT~ ~T~''Y that I have no intcatiaa to return to ~ T ormer C 1 E
- .
~o~~ 45'7435
1979 SEP -6 P!~ i2~ 58 - -
- - - fol. ANO EECUrc~EO
~T IE COUtlTTY.FtA.
R POITRAS .
• CI.RCWT COURj~ -
- !iE~A~•YCRIffEd__~ 1~~ ~
' j° 1t7~ .
' - l9 plamt~
- - t 9 J. ~ -
/ •
Sw~ors to aa~d saner befoo+e me tlms T~ dad os • , . , ~ - r
Ana/. ~ / • ~ t. ~ Li ~ i - •
K-, °GiRGUiT GOl~2T =•Q;~GJ t ?~'~s^ Q z-•` • .
ST• LUGS ~ • X1'.7 .rJt ~~~:r
•M: i ``V ~ .7
PUT t.ERK ~ *
~ s
• ~ a~x -