HomeMy WebLinkAbout0941 -
p,. _ - ~ - - -
- -
_-G-~ I+-T ~Ci ti i"E~"i"iR'~J i ~~`t3~ Y`~i~Yt."aYC~ ~ , ~ t.~ ~.~_.`~-r~`t~ _ _
' 458336 . ~
~oo~ca.~nxoF~ecmcurroou~r, .
s~:. Lyc ~ E ~ oovrrr~t, l~ol~n~: .
,
~;;'T6is is ap ai and ~ th. star. et Florida that I am this d~ is~aeme+dano.. ind ~
. _ eoafiorad~ vKti Seelios 1.17. Florida Statnles.
.
- • Iwastakgalresideata[ ~o 6 ~ ea w S _ ~ L Li i11,~ o
~
~ ands
tdtaW
resided d ~ ~ ~ Te I~ o u l
~f 6 u R V _ Howe~v, I haw cLanpd a~ domidM to
ts~..caaaH.r.~
. snd am and ~ bean a bona bde rssideat o[tbe State oit7oe ida ataee .l ~ ~ d.
~ ~..1~ ~ .1~~., and I raside at 31 ~1 ~ ~
PT S r L u e~~ _ ST, I.UC t E
.
and tlYis ststemeat is to be talcea ss aq deeLration d dtiseaaLip. actual legal residence and daonieiie is the State d Florida.
If iOR THE PURPOSE Of ENROLLING If FOR HOMESTEAD PURPO'lsESi
CHILDREN IN SCNOOLr- PLEASE STATE PL.EA$E CHECK:
THEIR NAMES: _
- X19 SEP i 2 Pii IZ~ 33
~?NOppr~~~co~u _ _
- RtO~iR
POIT AS~•
CiERItCtRttNT, _ - -
fiEt~ltp VERIFIED -
~s.
_458336 -
t
I F(TATSElt CIItTlF'Y that I w>'Il register a# m> >on1 sddress when the seaistaation book::eopea, and complT with aD
other req d a legal resided d Ibis State. ~ -
I F[JAT~ G'l~!'B''Y that I brn m intention to return to mT former domiale. snd I intend to remain in "
_ - - - _ -T. _UC1E -C.o'o~ntJ.
Florida. pei- '
- ~ - ~ couN~, ~ 3~ ~e~
. - _ vJ~~ c~Rt ~
Sys to and sabsQibed bxfa~e me thin daT a[• j"' s T ~tLe-.f ,e'. - ~~1.c1,
1 _
~.~79 " _ ~ .
K~OF''C1RCUIT GOU2T
ST. Lt~l E COl~+1T1l, ~D~A _ .
BYi =:Y.. ~ a
• EPUTY LERK