HomeMy WebLinkAbout0498 - ~ - - _ _
- DaciaratiQn of t~onriic~i~ and ~itr~enship .
sT~ Luc t t .~aovrrrY. Flroluca: ~ ~ _ -
Tbds a ~ d.~lzratioa or DomiaM aQd to the slag. et I~orida that I ao~ ~ this ~ Ln aeoonaase~. sa?d is
vita sew t~az, Statute.. -
I was :legal raddeat at ~--c'~+~'~ ~ ~ ~ ~.._~.P asa ~ .
:+esided st - ~ ~ JC. . c,~ , ' (L~ - However. I haw .
i8~rwcisittsl~~'~,~ ~ - -
and amandl~ve bssn aboos Bderesident otthe State of Florida sinus ~ . ` ~ ~ ~ daj of -
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19___ (1
n_ snd I reside st ~1 ~!a ~ t e = .
r
9
_ ~ D ~ ~ ~ - ~ ST. lUClE - F7oei~la.
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and this statement is to be taken as n~ dee~arstioQ of eitiasaship, actual keel resid~Lee and doeaieDs in the 8tste a[ Florida..
• ! FOR THE PURPOSE OP EItROLt. I hC I F • FOR HOMEST1rA0 PURPOSESs
CN i t•OREN I N SCHOOL, PLEASE STATE .PLEASE -CHECKS
- -THEIR NAMES: -
. - - ` ~ _ 1980 .IAN 2 ~ PN x ~ 5
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1;LER1~
- - - - ilECOR6 YEpp'1Ep~...~~--- - -
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I P'IJBT$F.Ii CERTIE'Y that I w~l register at mT iQcal address when the registestion boob: r+sopeo. ,ind oomtdy with all
• other regmreioents of a legal resident at thi+ State. - -
I FUItTI~ CERTIFIC that I Gave ao inteatioa to return to m~ former domia7e.- and -I--intend - to remain in
t)CIE
- _ . Couat7.
lei - -
Florida. permaaeur3; . - -
~ ~ G O J,yrf, ? ~
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sly, x.~•``~'~ ~c O~ V1•
Sworn to and '~•a aoe this °21 day oI - -
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- ~ a.k A.D.19 _V
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ROPER PO l TRAS. C!~ ERK OF C ! RCU I T COtd~2T
ST. L UC ! E COUNTY, f LOR 10A - _
. - ~ s.
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BY: -
- EPUTY ~¢tt~ ~ _
- . - 800 t~E