HomeMy WebLinkAbout0673 • Dec{arafion. of Dor~ici{e and Citizenship .
504.48 ~ ~
TO THE CLERK OF THE CII~CiJIT OOLTHT.
ST . L UC 1 E OOUNTY. FLORIDA:
- This b m~ dee]aratioa od Domia'Ie sad G~tissaship;a the State d Fsof'ida that I am Sfiaa this dq in seoadaaee. and is
- oootormit~ wkh Section ??2.1T. F'lofrida Statntss. -
I was iora~er a legal rssideat ad ;~1t- i t e fi e l d , - ~ - bta~~ n e and I
1pt71 - 18w•1
resided at h FD 1 , I3 n;
t 12 G., A 1 n a R ~ ad _However. I have changed m4 domieiis to
tsa.aa,a>N~s.~l .
and am and have been a bona 5de resident d the State d Florida aina (~c ~ ot-• c r 16 , ~ dy ~
19_iQ..aadIresideat - 57~ Azalea !`~~-cr,~:e
- lfttn~t ad I~ioab.N
t _ ~ ~ ST. LUG I E CountT.h3odda.
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and this statement ~is to bs taken ae aoP deelaratiaa of dtisenship. adaal legal resideaos and damio'is to tbs State d Florida.
' IF FOR THE FURPOSE'Oi ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN•IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMESS -
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~s ~ nr1 re~a T ~ i~rnl n }
- 19c0 OCT 2 i Ale: i I ~ 13
?ilzE RApr{i.t~riK~
51-LUCIE CQiJ!i'Y.ft A.
- - ROGER POftIRAS
CLERK C:RCLtT CLtl~I
- ~ 504148
I Ft1RTHEB C~1'll:'Y that I wiII re6ister st mT k+nl address when the regitratioa boobs roopea. and eompb wits aD
other regniremeata d a legal raodeat d t>sis Btate. -
- - i
I FtlRT1IER CIIi1ZFY that I have ao intcation to ret~n to taemer domiei7e. and I intend to remain in -
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- - - - - ceonti. ,
_ tac~1 -
Florida. permaaaau; . -
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~„•,.•°.a_E?•~'
~ _ Diane : ,.Li nc~? n
s ,r'v~.~ 509 Azalea A-~•enue
21 St ~-ir ~ ?
S ~t!~ G~ beiee+e me this dad d Ft . crce , F'. , _ 3
' ~ •
Octo~-~er ~~.19
I ROGER POI TRAS. CLERK OF CIRCUIT COtdFtT ^ ' '
ST. LUG i E COUNTY, fLOR 1 OA _ .
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