HomeMy WebLinkAbout0250 -
• ~ -
•
Declaration of Domicile anti Citizenship
ST. t; UCH r E - o0tn~[. rzolltoA~ .
316 6 mP dsdaragoa d DooiiafN aad pt6easD~ is tbs 81at~ at Florida tlOt I ass ~t this dy is aooacdaaos. and is
con6ormitP witD 8.etioe s>sa.xz, l~lorids Statutes. -
. I was f s lspi raWraR d Yet j ~ ~ and I •
L ' . It~gl I~aai
t~eaided at N 1 ~ • Ho~wawa:. I Dan c6~nEad ap domieII~ to
(eah.t..~ Ni¦~Mel ~ ~r. ~ -
and am and base besa a bona 8de resident d tDs State d Floeida s6+a r"'_ ~ d q d
' 11~.fl.=.. and I reski~ at - ~ ~ ~l1 ~ • Q %ro 5 0 ~U
-~a I'T , cJT, ~ Gt,G~,~°~ ST. LUC 1 ~..~H..e.e) Wis.
t~
and tb6 rtatemast i~ to bs talon ss ~ dsdaratloa d , aetoal 6aat reeidenes and domddN io tDe State d Florida.
- - If FOR THE PURPOSE Of ENROLLING IF iOR HONE8TEA0 PURPOSEB,
CHILDREN IN SCNOOL, PLEASE STATE PLBABE CHECKS
THEI NAMEB:
• n6IUQ ?4 G / M
- -
_ - ~ Rtc~l~ls v~~~rKn . r
~
4'~50a4
I FZIRTIIER CSATD+'Y tbst I wilt at aq ioeai address wbaa the reg6fratioa books reopen, and eampb wtt6 aII
other regeiremeate d s kaal t+saideat d tDb State.
I FUA3~ C~TI>!'Y tbst I Ds~e no tsteatioo to ratnrn to former sad I 6tead to remain is
_ 1 E _ Co+mt7.
= - (a4l
F7orida+ P~i • ~
_
_
't AA..F
`tip ~ •'7 -r.i ~
- .i.~ ~ - ~,Jv
• ~ . j~~/ ~
~ ~~7 •
1 ~
Sworn to and aobseribad before rile tD6 ~ ~ dy d J
ROGER P~OITRAS, CLERK ~ C~lRCUI T CART
• -
ST. LIIG 1 E COUNTY, fLOR t0A ~ -
BYs - ~ a
_ EPU LER
y
' ` ~