HomeMy WebLinkAbout1393 • ~ ' a ` ~wr
U~c;iara~tior, ur t~uii~ii~;i1~ ar~c~ Li~~zer~shi~ ~
' 4b8163
TO THE CLERK OF THE CIItfIL11T COURT.
ST•. L. UC 1 E fJOUN'1'Y. FLORIDw: .
This is nq deeLration of Domide and Citizenship in the State of Florida that I am AinS this dad is aooordaaoe. and is
_ eonformit~ with Section 222.17. Fbrida Statutes. .
I was formers a kgal resident of ~~O 4/ r _ ~ ~ 1` ~(OPl and I
1(st~l lSeaeal
resided at Aowever. I have changed m~ domiale to
Istieet and Nambet) P
and am and have been a bona fide resident of the State of Florida since ~ g` - _ dad os
~ 19 and I reside at `J ~ ~ N ~ R t £ 3~ ~ ~ ~ . ~~.-~~„'4
1~7~
(Sa..t asd Nmb.rl
R'C ~ ~ & R ~ t ~ ST . L UG i E Countj. Florida.
fGt~l
and this statement is to be taken as m~ declantioa of citizenship. actual legal residence and domide in the State of Florida.
i
IF FOR THE PURPOSE OF ENROLLING IF f'OR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: /
THEIR NAMES: ] v
_ - ~ -
ft LEO ~N' t ' ~Epp
i~.lUClf _.~~..ti: • ELA.
R~JG~ ~ .~S
RECOP' ~ - =~c r n
- - Dec ~ 2 25 P~ 7~
48163
i
I FURTHER CERTIFY that I w~71 register at m~ local address when the registration books reopen, and oomph with aD
other requirements o[ a legal resident of this State.
~ I FURTHER CERTII~'Y that I have no intention to return to m~ former domicUe. and I intend to remain in
T U C E Counq.
_ 1(Sc~l
Florida. permanenci,:
•.•.:~r~t:~::~ .
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IAddrNS)
Sworn to ~tsbti3lsibed before me this ~ daT of
a C I .A.D.19~
. 79
ROGER P01 TRAS. CLERK OF CIRCUIT COURT _
•
ST. LUGIE COUNTY, FL 1DA - -
' - •
BY: ~
_ EPUTY LERK n
Boox32i PaCE~~~ _