HomeMy WebLinkAbout1571 ~ -
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- De~tar~tion of Domicile end citizenship
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TOY'HR (~.ERK Ole THE CDZCUTP ODUAT. -
ST. tUG 1 E oovrrr~r:lR.oRIDAs
- ~'bie is my aeea:atioa a[ DomidN and #o tbs'Staie oI lofcrids that I as ~i thin daF is aeso:daaae. and is
- eoafottaitT with Sactioa 8ii$.17. Irlorida ~ / -~~-1 -
. ~ I wa f a Mdst naideM d /Y'~l
5/LL/~~~.. ~ ~ ~ mot/ sad I
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resid.d a _~~~:...~kl~.E~~~l t~ ~ - Aaw.~.e. I bav. stiasis~d ~ domie$a to -
taq..e•.+Hee~Deel = .
- and sea and bane a baoa 8de rssideot of tb. State d F>a~rids aims- - ti - - - - - - - - dy et
R . li1~ aalieaide at ~'~t.~5 e - s`~~C- -
hc,~~ S-t ~vC~ ~'J ST. LUGIE~~ -
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aad this statameot b to be taken a. m f dadatition d dt, adnal ksat red~ksa sod 8omielM is t!~ State aI Floeida.
IF FOR T-HE PURPOSE OF ENRO~LINa If FOR HOMESTEAD PURPO$ES~
CH 1 t.DREN f N SCHOOIa Pt,EASE STATE. - - P~~EASE CHECKS -
THEIR NAMEES
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I FUBT~ CSATIFY that I wID ragider d ~ k~eal address when the won books reopen. sad e~ with a8
j other regnirameate of a legal rsadent of this State. - - - - -
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f i Fg1ATHIIt CEIiTII~'Y that I bare ao intention to retmn to mT farmer domin7e. and I ioteod to remain is
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E ~larids, Peer
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S..aKn to and me this _ a ~ dp at - Ya ~-1 L c.~~r ~ ,
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RQGER -POIiRAS, CLERK OF GIRCUI T COt~2T -
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- ST. LUG 1 E -COUNTY, FLOR 10~A - t
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- EPUTY t,ER!( `
• - - AGE Farm 71.71`