HomeMy WebLinkAbout0665 • -
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~f'Cic~i'3~tC3ri oY uo~~i~iie ana ~<~~~ensiii~
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' 4Ei959'7
TO TSE Q.ERK OF THE CD;CUIT COURT. .
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S'i•,. LUG i E ppU~. ~,pgIDp;
;This is aa4 dedaration o[ Damidls and QtiaeaaLip is the State et 1:7orida that I am tLis
- _ oontormih with Seet3oe 2?S.1T. F7orids Statutes. ~ ~7 ~ aoooedanoe. and is
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- I was f
~ a legal resident e[ _ F+ey S~ o n/ T
t Xq- 5 and I
lt~71 . tses.i
resided at l I D o ~ N /I MM E IP 4 8) VII , Rowe~?et. I Law eLaagad ~ do~mia'la to
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and amend Lave been a bona fide resident of the State atFbrida ainee ~s ~ dad d
nFC rM ~E R -19
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- andIn~deat ~o`l~/D D~Fi4~d FJQ .
It~t~sd and Nmb.r)
P, E Rc E' ST. LUG 1 E ~h.~~ .
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and this stateme~ is to be taken as m~ declaration of dtizenship. actual legal residence and domiesle in the State at 1:7orida»
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL,•PLEASE STATE PLEASE CHECKS
THEIR NAMESS
~At.E T3ALDc,~i~,
LED AND k' ,.,..OED
- - ~ LUCIF . ` FLA.
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- DEC it 10 ~s aN 7~
- - - 4Ei959'7 I
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I FURTHER CRR1'~'Y that I wiII register at m~ local addrrss when the registration books reopen. and ~P17 witL aD
other negni:+ements of a legal resident of tLis State.
I FURTHER CERTlF'Y flat I have no intention to return to m~ former domic0e. and I intend to remain in
c~ - T- U C 1 E Counh.
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Florida, permanend;.
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K Swprn t0 and i11 me this did of __s ! ~~h l ~
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ROGER POITRAS. CLERK OF CIRCUIT COURT
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~ ST. LfIG1 E COUNTY, f LOR 10A
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- E P U T Y L E R K 8(l~ 322 'AGE +
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