HomeMy WebLinkAbout2099 ~~C~~t'caE~€~~l ~3~ aC3fi~tCt~P, t~~€'.a ~~'~~~:~~~~i,=_.
. -
4b1044 - -
TO THE t~.ERK OF THE CIROUIT OOURT. _
_ST. _Ll>r 1 E oovrrrY. FLOxIDA:
-
1~`iilapr dieeTarstion oI Domicils and (~tiaeas>tip is the State at Florida that I am ~i this dp is •oooe+dasee. and b
wilh Ssetios 222.iT. >:'lorida Statutes. .
v Iwasakgalses~e~et ~~l tV ~i2,C•,~W ' _ cam. C~Tt A N ~ andl
10141 lee•W
resided ~ `S W E'sT - f~i.'Tahl ``^..izoss wry - - _ gowever. I have ehanaed mF domidl. to
- 1sa..caadldgob~el
_ and am and have been a bona Sde resident oI the Mate of Florida ainoe nn ~ d'
SE Pi~hAgs~ .1~_~. and I reside at ~ • ~ • r'a!~C~r4L~T. I~QT cSi ~..yC`1 t _
. 18n..t a~dlloDrd
_ -ST. LUG 1 E Coongr. Floeid:.
-
and this statemeat is to be ta><en as aq deelaratiop o[ eitisenship. adnal legal residence and domicile in tbs State d h7orida.
~ - -
ii iOR THE PURPOSE Oi ENROLLING Ii fOR HOMESTEAD PURPOSES,
CNItDREN iN SCHOOL,-PIEASE STATE PLEASE CHECKS
TN~1R NAMESS -
rRw /4tV02t'tiv B1 L3L.t- - _
<30~ ~e~w~ - ~LaL~ _ - 1919 ~T -2 A!! t!= 36 -
~ENNC--n,? ~~G~L_ P~ ,J~ gL•[_ F 0 A RECORQEO
g~ COUNTY.FIA.
_ x(06 POITRAS-
CtI1Ot CIRCUR. LOUR I
RECORD Yl:RIFtED.,
- 461044
I F(JAT~R CF~IT)l'Y that I will register at mr local address when the registratioa books reopen, and eompl~ with all
other regmnmeats at a legal resident ad this State.
I F[)RTHER CF~iTIFY that I have no intention to return to m7 former domio'le. and I intend to remain in
. U C E ConntT.
Il~i4) _ -
Fbrids. permanend;.
i
i
-
.
~~GO~N ? Ut~nc~~ ~..g~
gy,...~~ , Tyc -
G~--; ~ -
U ~ ~ ' ; : to ~ - - 1Nao~
~ ' before me this daj of 429' ~ ~C~ E
o~~dd .~.D.~; 79 yf~~~NKE B ~ b ~.e) -
ROGER POITRAS~ CLERIC OF' C IRGUI T GOURT-
ST. LUG 1 E COUNTY, - FLOR 10A - _
- EPUTY IERK ~t~,~+~J
- 8D~ J.~i. ( 1'~E~~ .
t