HomeMy WebLinkAbout2365 Utlst;_ t ...L i. :11 iJ;.:. <<! t:..! ~tii ;51111.)
. ~
"iv502C7
'>;O THE CLERK OF THE CIRCUIT COURT.
S~. L UC i E COj~ry~ ~,O~A:
~ 4'hia is my decl:ratiaa of Damiulz sad G~+,i:,-ship in tht S*_.a±s of Florida that I am Ong this day in accardanoe. and is
conformity with Section 222.17, Florida Statutes,
I wu formerly a legal resident of ~1~(L~ ~/t'~f ~ d and j
r
_ ~ ICrt~) . ISI+W
resided at ~ o tq i p ~ However. I have changed m) domiu~e to
(Stsset sad Numbs)
and am and have been a bona bde resident of the State of Florida since _ I ~ ~ day of
19~. and I reside at _ > ~ ~ ~ Ll I R Q
(Street and Nnmber)
P6 r S ~ t!..v~ L/ E ST . L UC 1 E County. Florida,
14t,)
and this statement u to be takes as my declaration of cltisenship. actual legal resideu~ and do~sia~c in tht S! :tz of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOLr~PLEASE STATE PLEASE CHECK:
THEIR NAMES:
Lls.9 ~av Qro~ti
L~~.~r~f} ~o%FR~ ~j'yw~v ~r -
- '3i9 ii07 -6 i
~ I 1
St~tlCiE CuU!! l Y. f l i..
R ER POIT~2AS
405028
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with aD
ocher requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to mp former doanict~e, and I in4nd to remain in
T. U C I E County,
ICit~) .
Florida, permanenti~.
_ ~
'v.
)
....:v.,•- ~ 3 I ~ l Prof p
LAddres~)
Swarm to snd robsrn'bed before me this N C
_ day of Pn r 1 5 l
.79
R9GER POITRAS. CLERK OF CIRCUIT COURT
~ ~ • •
ST. UG I E COUNTY, F'LOR t OA _ -
/ EPUTY LERK
~191•~~ x'353..
t
- -